A Child With Anuric Acute Kidney Injury With Subsequent Hypertensive Encephalopathy: A Case Report

TL;DR

A child with severe kidney failure due to a strep infection recovered fully without needing dialysis, showing that anuria alone doesn't always require it.

Contribution

This case demonstrates that anuria in AKI does not always necessitate dialysis, supporting individualized treatment strategies.

Findings

The patient achieved full renal recovery without dialysis despite 72 hours of anuria.

At five years post-treatment, the patient showed no residual kidney damage.

Medical management with fluids and diuretics was sufficient for recovery in this case.

Abstract

Acute kidney injury (AKI) is a critical condition in pediatric patients, often leading to significant morbidity and mortality. While dialysis is a key intervention in severe cases, it is not always required. This case report presents a pediatric patient admitted with AKI and anuria secondary to acute post-streptococcal glomerulonephritis (ASPGN). The patient underwent medical management, including intravenous fluids and diuretics, without requiring dialysis. Despite 72 hours of anuria, the patient achieved full renal recovery without renal replacement therapy (RRT). This case highlights the importance of individualized treatment approaches and supports the notion that anuria alone is not an absolute indication for dialysis. Delaying RRT in hemodynamically stable patients, in the absence of emergent indications, may be a viable approach. At the five-year follow-up, the patient had fully recovered without residual renal impairment.

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