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A previously healthy man presented with progressive oliguria and markedly elevated creatinine two days after freshwater near-drowning. Management included individualized fluid therapy, empirical antibiotics, and intermittent hemodialysis, with renal biopsy to define pathology. Histology confirmed acute tubular injury; seven dialysis sessions were required, followed by gradual recovery, discharge on day 11, and complete normalization after one month. Evidence suggests ischemia-reperfusion as a primary contributor, and biopsy supports diagnosis in ambiguous cases while early tailored supportive care improves renal outcomes.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/severe-acute-kidney-injury-after-near-drowning-in-a-healthy-adult-a-case-report/455105/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/severe-acute-kidney-injury-after-near-drowning-in-a-healthy-adult-a-case-report/455105.png","ImageObject",300,407,{"name":92,"@type":93},"Anna Hans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What condition was diagnosed in the reported patient after near-drowning?","Question",{"text":112,"@type":113},"The patient was diagnosed with acute kidney injury (AKI) secondary to near-drowning. Renal histology later confirmed acute tubular injury.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What treatments and diagnostic procedures were performed?",{"text":117,"@type":113},"The patient received individualized fluid management, empirical antibiotics, and intermittent hemodialysis. A renal biopsy was performed to clarify the underlying mechanism.",{"name":119,"@type":110,"acceptedAnswer":120},"How did the patient’s kidney function and urine output change over time?",{"text":121,"@type":113},"Urine output and renal function gradually recovered after dialysis. The patient was discharged on hospital day 11, and renal function completely normalized after one month.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},455105,1790816755,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},5909892332657,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","®  \n Clinical Case Report   \nSevere acute kidney injury after near-drowning ina healthy adult  \nA case report  \nJihao Xu, BSa ,b , Bin Zhu, MDb ,*  \n\n| Abstract\u003Cbr>Rationale: Acute kidney injury (AKI) is an uncommon but serious complication of near-drowning, and its underlying mechanisms remain poorly defined. Existing evidence suggests a multifactorial process, yet reports with integrated clinical and pathological evaluation are scarce.\u003Cbr>Patient concerns: A previously healthy man in his thirties presented with progressive oliguria and elevated serum creatinine 2 days after a freshwater near-drowning incident.\u003Cbr>Diagnoses: AKI secondary to near-drowning.\u003Cbr>Interventions: The patient received individualized fluid management, empirical antibiotics, and intermittent hemodialysis. Arenal biopsy was performed to clarify the underlying mechanism.\u003Cbr>Outcomes: Renal histology confirmed acute tubular injury. The patient underwent 7 dialysis sessions. Urine output and renal function gradually recovered, and he was discharged on hospital day 11. Follow-up after 1 month showed complete normalization of renal function.\u003Cbr>Lessons: AKI following near-drowning may be multifactorial, with ischemia-reperfusion injury being the primary contributor. In ambiguous cases, renal biopsy can provide valuable histological evidence to support diagnosis and guide therapy. Early recognition and tailored supportive strategies are essential for renal recovery.\u003Cbr>Abbreviations: AKI = acute kidney injury, ATI = acute tubular injury. |\n| --- |\n| Keywords: acute kidney injury, drowning, ischemia-reperfusion, renal biopsy |\n\n1. Introduction  \nDrowning is a major cause of unintentional injury-related death worldwide, particularly in low- and middle-income countries, as reported by the World Health Organization. [1,2] In survivors, in addition to life-threatening respiratory failure, multiorgan dysfunction may occur, including acute kidney injury (AKI). AKI is characterized by a sudden decline in renal function, leading to the accumulation of nitrogenous waste (e.g., creatinine, urea) and impaired toxin clearance. [3] AKI occurs in a substantial proportion of drowning survivors, with Gorelik et al reporting an incidence of 43%, including 18% with stage 2 to 3 disease. [4] When present, it can be clinically severe and is linked to poor outcomes if not promptly treated. The pathophysiology is multifactorial, involving ischemiareperfusion injury, rhabdomyolysis, hypovolemia, and nephrotoxic exposure. [5] Notably, few case reports have described post-drowning AKI confirmed by renal biopsy, especially those  \nWritten informed consent was obtained from the patient for publication of this case report.  \nThe authors have no funding and conflicts of interest to disclose.  \nData sharing not applicable to this article as no datasets were generated or analyzed during the current study.  \na Department of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China, b Urology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.  \n* Correspondence: Bin Zhu, Urology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital,  \nwith complete renal recovery. Given the potential severity and diagnostic challenges, early recognition and timely supportive therapy are critical for improving patient prognosis. We report a biopsy-proven case of severe AKI requiring renal replacement therapy in a previously healthy 35-year-old man following freshwater drowning, which provides crucial insights into the underlying pathophysiology and the role of individualized management.  \n2. Case report  \nA 35-year-old previously healthy man presented with a 2-day history of oliguria following a freshwater near-drowning incident during recreational fishing in the Fuchun River. He had accidentally fallen into the river","cbCaikww2KtJZrZU","https://ap.wps.com/l/cbCaikww2KtJZrZU","pdf",707766,"English","# Abstract\n# Introduction\n# Case report","[{\"question\":\"What condition was diagnosed in the reported patient after near-drowning?\",\"answer\":\"The patient was diagnosed with acute kidney injury (AKI) secondary to near-drowning. Renal histology later confirmed acute tubular injury.\"},{\"question\":\"What treatments and diagnostic procedures were performed?\",\"answer\":\"The patient received individualized fluid management, empirical antibiotics, and intermittent hemodialysis. A renal biopsy was performed to clarify the underlying mechanism.\"},{\"question\":\"How did the patient’s kidney function and urine output change over time?\",\"answer\":\"Urine output and renal function gradually recovered after dialysis. The patient was discharged on hospital day 11, and renal function completely normalized after one month.\"}]","Severe acute kidney injury after near-drowning in a healthy adult - A case report | PDF",1790742126]