A Case of Severe Acute Kidney Injury by Near-Drowning

Abstract

Acute kidney injury (AKI) secondary to near-drowning is rarely described and poorly understood. Only few cases of severe isolated AKI resulting from near-drowning exist in the literature. We report a case of near-drowning who developed to isolated AKI due to acute tubular necrosis (ATN) requiring dialysis. A 21-yr-old man who recovered from near-drowning in freshwater 3 days earlier was admitted to our hospital with anuria and elevated level of serum creatinine. He needed five sessions of hemodialysis and then renal function recovered spontaneously. Renal biopsy confirmed ATN. We review the existing literature on near-drowning-induced AKI and discuss the possible pathogenesis.

Acute kidney injury after near drowning: The way from the beach to hemodialysis

“…Also in this retrospective analysis—like our case—“isolated acute renal injury” was defined in this group as requiring hemodialysis without overt extrarenal findings especially in the respiratory system. The cases with severe isolated AKI after near drowning are very seldom reported . Pulmonary infiltrates are common after near drowning, which may cause pneumonia and respiratory failure, but chest radiography of our patient did not show any infiltrates, and thorax CT revealed bilateral pleural effusion.…”

“…The cases with severe isolated AKI after near drowning are very seldom reported. 2 Pulmonary infiltrates are common after near drowning, which may cause pneumonia and respiratory failure, but chest radiography of our patient did not show any infiltrates, and thorax CT revealed bilateral pleural effusion. Except for acute renal failure, also severe electrolyte disturbances may be responsible for the indication of hemodialysis.…”

“…Only a few cases were reported which required hemodialysis after near drowning. 2 In our patient, although he was under observation for 24 hours, renal injury occurred days after the occasion, rather mimicking a postrenal etiology or urinary tract infection at admission. Unfortunately, the exact pathogenesis of acute renal injury after near drowning has not been well defined and understood.…”

“…Near drowning is a rare cause of acute renal injury, but patients who experience this catastrophic situation should be closely followed up about this complication. Only a few cases were reported which required hemodialysis after near drowning . In our patient, although he was under observation for 24 hours, renal injury occurred days after the occasion, rather mimicking a postrenal etiology or urinary tract infection at admission.…”

Patterns of multiorgan dysfunction after pediatric drowning

“…As stated previously, pediatric drowning literature has focused on individual organ dysfunctions 3,7,24,26,27 . Lung injury, frequently reported in the drowning literature, is characterized by abnormal surfactant function and increased capillary endothelial permeability 7 .…”