Anuric Acute Kidney Injury Requiring Dialysis Following Acetazolamide Use for Cataract Surgery

Abou-Mrad, Rana M.; Ibrahim, Mazin; Osman, Nuha; Babu, Raman Suresh

Patient: Male, 62-year-old Final Diagnosis: Acute kidney injury Symptoms: Anuria Medication:— Clinical Procedure: — Specialty: General and Internal Medicine • Nephrology • Ophthalmology OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Acetazolamide (ACTZ) is commonly used in the prevention and treatment of various clinical conditions, and anuric acute kidney injury (AKI) is one of its known life-threatening complications. CASE REPORT: We hereby report the case of a middle-aged man known to have compensated heart failure and hypertension with previously normal kidney function, who received a total dose of 2250mg of ACTZ over 3 days after cataract surgery. One week after the operation, he presented with anuria and severe bilateral renal colic, as well as progressively worsening kidney function and metabolic profile, which eventually required hemodialysis prior to recovery. CONCLUSIONS: The cause of the AKI was attributed to intra-tubular obstruction by ACTZ-induced crystalluria, which required discontinuing the offending agent and dialysis to correct the kidney functions.