Case Report: Uremia secondary to acute pyelonephritis in a patient with type 2 diabetes mellitus

We report a 58-year-old male patient with acute kidney injury (AKI), who eventually developed anuria secondary to acute tubulointerstitial nephritis (ATIN) following acute pyelonephritis. Our patient had a 10-year history of type 2 diabetes mellitus, with an admission glycated hemoglobin (HbA1c) level of 6.3% and no prior history of renal disease. Before admission, he presented with painless gross hematuria and fever. Escherichia coli was detected in the urine culture at the local hospital, and anti-infective normalized his temperature, but urine output progressively decreased to anuria. After transfer to our hospital, renal biopsy confirmed ATIN. Following treatment with glucocorticoids, the patient's urine output gradually increased, and renal function gradually recovered. During subsequent follow-up, the patient achieved complete remission with a favorable prognosis. For patients with a history of type 2 diabetes mellitus who develop anuria without typical manifestations after acute pyelonephritis, early completion of relevant examinations, clear identification of the etiology, timely treatment and regarding medical follow-up are crucial to maximize the improvement of the patient's prognosis.