DOI: 10.36347/sjmcr.2018.v06i09.031

Pages: 717-720

A 23-year-old man began drowning when he suffered a leg spasm while snorkeling in the ocean. After being rescued, he showed consciousness disturbance and a pale face. On arrival, chest roentgen showed decreased radiolucency in the bilateral lung fields. The level of uric acid was 18.4 mg/dl. He received tracheal intubation for mechanical ventilation with positive end-expiratory pressure. After admission to the intensive-care unit, his respiratory function improved, and he was extubated on the second hospital day. However, he became complicated with oligouria and showed a daily increase in his creatinine level. He also became complicated with lung edema due to acute renal failure, so intermittent hemodialysis therapy was started on the fourth hospital day. After six hemodialysis sessions, he spontaneously obtained sufficient urine flow, and the levels of both creatinine and blood urea nitrogen decreased without hemodialysis. He was ultimately discharged on foot. Acute renal failure after nearly drowning to death is not very rare, so physicians should pay close attention to this complication in near-drowning patients. Hyperuricemia may contribute to the occurrence of acute renal failure after nearly drowning.