A Case of Acute Kidney injury After Seawater Immersion

Korean Journal of Nephrology 2010;29(2):247-249.

Jae-Seok Park, M.D., Jung-Hoon Kim, M.D., Hyo-Wook Gil, M.D., Jong-Oh Yang, M.D., Eun-Young Lee, M.D. and Sae-Yong Hong, M.D.

Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea

증례 : 침수 후 발생한 급성 신손상 1예

박재석, 김정훈, 길효욱, 양종오, 이은영, 홍세용

순천향대학교 천안병원 신장내과

Abstract

Acute renal failure (ARF) secondary to immersion and near-drowning has rarely been described and it is poorly understood. ARF associated with immersion and near-drowning might be involved with systemic tissue hypoxia, hypovolemia and hypothermia. Some reports have shown that rhabdomyolysis could be involved. We report here on a 52 year old seaman who developed ARF after cold sea-water immersion. He had been swimming for one hour in cold sea-water because his ship became stuck on a rock. After 2 days, his serum creatinine level was increased to 7.8 mg/dL, and pulmonary edema was developed. The serum myoglobin level was 495.1 ng/mL. He was diagnosed as oliguric ARF and treated with hemodialysis. Thereafter, renal function was gradually recovered. We presumed that hypothermia-induced vasoconstriction, hypovolemia and rhabdomyolysis were involved in ARF in the patient. It should be considered that cold sea-water immersion for a long time could evoke ARF in healthy men.

Key Words: Hypothermia, Acute kidney failure, Immersion