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Hyponatraemia-induced rhabdomyolysis complicated by anuric acute kidney injury: a renal replacement conundrum
  1. Paul Secombe1,2,
  2. Chris Milne2
  1. 1Faculty of Health and Medical Sciences, University of Adelaide, The Joanna Briggs Institute, Adelaide, South Australia, Australia
  2. 2Department of Intensive Care, Alice Springs Hospital, Alice Springs, Australia
  1. Correspondence to Dr Paul Secombe, paulsecombe{at}


Hyponatraemia-induced rhabdomyolysis is a rare, but reported phenomenon, particularly in patients with chronic schizophrenia on depot antipsychotics prone to psychogenic polydipsia. To the best of our knowledge, there are no reported cases of hyponatraemia-induced rhabdomyolysis complicated by oligo-anuric acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). The initiation of CRRT is complicated in severe hyponatraemia, predominantly due to the need to avoid rapid changes in tonicity associated with rapid changes in sodium. We report a case of severe hyponatraemia (104 mmol/L) complicated by oligo-anuric rhabdomyolysis-induced AKI and our management of the renal prescription.

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  • Contributors PS made a substantial contribution to the conception and design of the article, drafted the discussion and critically reviewed and revised the case report. CM made a substantial contribution to the conception and design of the article, drafted the case report and critically reviewed and revised the discussion. PS and CM have given final approval for the version to the published and accept responsibility for the accuracy and integrity of the work.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.