AACE Clinical Case Reports (Jan 2015)

Fulminant Type 1 Diabetes in an 81-Year-Old Male with Rhabdomyolysis-Induced Acute Kidney Injury Successfully Withdrawn from Hemodialysis: A Case Report

  • Satoshi Yamagata, MD, PhD,
  • Kazunori Kageyama, MD, PhD,
  • Jun Matsui, MD, PhD,
  • Hiroshi Murakami, MD, PhD,
  • Maki Yamashita, MD, PhD,
  • Shingo Murasawa, MD,
  • Miyuki Yanagimachi, MD, PhD,
  • Makoto Daimon, MD, PhD

Journal volume & issue
Vol. 1, no. 3
pp. e208 – e211

Abstract

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ABSTRACT: Objective: Fulminant type 1 diabetes mellitus (FT1DM), a distinct subtype of type 1 diabetes, is characterized by a rapid onset of severe hyperglycemia and diabetic ketoacidosis (DKA). DKA sometimes induces severe rhabdomyolysis, which causes renal failure, and it requires permanent hemodialysis (HD), especially in elderly patients. Some cases of FT1DM progress to rhabdomyolysis-induced acute kidney injury (AKI).Methods: We report the case of an 81-year-old male with rhabdomyolysis-induced AKI, the oldest patient reported to date, associated with acute FT1DM onset.Results: Although the patient required HD, he was successfully withdrawn from HD within 2 months.Conclusion: Even in such advanced age patients, prompt renal replacement therapy gives the prospect for recovering kidney function and circumvents the need for permanent renal replacement therapy.Abbreviations: AKI acute kidney injury CHDF continuous hemodiafiltration CK creatinine kinase DKA diabetic ketoacidosis FT1DM fulminant type 1 diabetes mellitus HD hemodialysis HLA human leukocyte antigen RRT renal replacement therapy