23 February 2026
: Case report 
Bilateral Renal Shutdown: A Rare Case of Reflex Anuria Causing Acute Kidney Injury
Rare disease
Paolo Nikolai So
ABCDEF 1*, Runako A. Aranha-Minnis BCDEF 1, Donovan Persad EF 1, Walter Y. Agyeman EF 1, Alfred Solomon ACDEF 2
DOI: 10.12659/AJCR.951874
Am J Case Rep 2026; 27:e951874
Table 1 Initial laboratory results.
| Parameter (units) | Result | Parameter (units) | Result | Urinalysis | Result |
|---|---|---|---|---|---|
| Sodium (mmol/L) | 127 | WBC (10/μL) | 18.9 | Color, appearance | Amber, cloudy |
| Potassium (mmol/L) | 3.9 | Hemoglobin (g/dL) | 12.3 | pH | 6.0 |
| Chloride (mmol/L) | 93 | Hematocrit (%) | 37 | Specific gravity | 1.009 |
| CO (mmol/L) | 23 | Platelets (10/μL) | 249 | Protein | 2+ |
| Anion gap | 15 | Neutrophils (%) | 86 | Glucose, ketones, bilirubin | Negative |
| BUN (mg/dL) | 39 | Lymphocytes (%) | 7 | Urobilinogen | 4.0 |
| Creatinine (mg/dL) | 3.6 | Osmolality (mOsm/kg) | 271 | Blood | 2+ |
| Glucose (mg/dL) | 106 | Urine osmolality (mOsm/kg) | 172 | Nitrites | Positive |
| Calcium (mg/dL) | 8.5 | Random urine sodium (mmol/L) | 33 | Leukocyte esterase | Trace |
| Total bilirubin (mg/dL) | 0.4 | Random urine uric acid (mmol/L) | 11.9 | Red blood cells | 5/HPF |
| Lactate (mmol/L) | 1.0 | Random urine protein (mg/dL) | 155.0 | White blood cells | 21/HPF |
| CK total (U/L) | 192 | Random urine creatinine (mg/dL) | 46.2 | Bacteria | Few/HPF |