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Anuric Acute Kidney Injury following a Caffeine Overdose: A Case Report with Biopsy Results
Kezia T McWhan1,2,3, Marie H Vrist1,2, Søren P Krag4
1University Clinic in Nephrology and Hypertension, Gødstrup Hospital and Aarhus University, Aarhus, Denmark.
Introduction:
Caffeine can be lethal at approximately 10 g, but overdoses can also cause acute kidney injury (AKI). Some cases of caffeine-induced AKI have been described, but histopathological presentations of this phenomenon, as presented here, are rare. Hemodialysis has been reported in several case studies as a therapeutic option for removal of caffeine and caffeine metabolites.
Case Presentation:
A 43-year-old male suffered AKI after ingesting 10 g caffein pills in an attempted suicide. He was hemodynamically stable. Hemodialysis was initiated to remove caffeine and caffeine metabolites, as the patient was anuric and displayed new-onset QTc-prolongation. Hemodialysis was stopped after 14 days, and the patients' renal function gradually fully recovered. Kidney biopsy on day 7 showed mild tubular injury.
Conclusion:
The case illustrates a rare case of anuric AKI after a caffeine overdose. AKI was fully reversible after treatment with hemodialysis. The kidney biopsy showed mild tubular injury with no clear evidence of myoglobin casts as seen in a previously published case.
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