Severe Acute Kidney Injury Secondary to Rhabdomyolysis in Diabetic Ketoacidosis (DKA): A Case Report

Delayed diagnosis and treatment of rhabdomyolysis in diabetic emergencies may lead to irreversible kidney damage and progress to chronic kidney disease. Therefore, early detection and correction of electrolyte disturbances, resulting from diabetes and risk factors for rhabdomyolysis, is essential to avoid complications and renal function improvement. In this case report, a patient with two weeks history of polyuria, polydipsia, and nocturia showed up at ED with epigastric abdominal pain, nausea, and non-bloody vomiting. The patient was in a diabetic ketoacidosis episode in which rhabdomyolysis developed and complicated into acute renal failure. Few case reports in the literature have mentioned the association of hypophosphatemia, severe acidosis, and high osmolarity as contributors to rhabdomyolysis leading to acute kidney injury (AKI) in patients with hyperglycemic emergency cases. To our knowledge, this is the first case reported in Saudi Arabia. Therefore, our unique case sheds some light on an overlooked complication in diabetic ketoacidosis (DKA), rhabdomyolysis, in which electrolyte abnormalities are the most probable trigger.