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CEN Case Reports

, Volume 6, Issue 2, pp 200–205 | Cite as

Acute kidney injury caused by decompression illness successfully treated with hyperbaric oxygen therapy and temporary dialysis

  • Arata HibiEmail author
  • Keisuke Kamiya
  • Takahisa Kasugai
  • Keisuke Kamiya
  • Satoru Kominato
  • Chiharu Ito
  • Toshiyuki Miura
  • Katsushi Koyama
Case report

Abstract

A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints. Hyperbaric oxygen therapy (HBOT) was immediately administered. His symptoms improved after the first course of HBOT, however, the patient had anuria for almost 36 h after admission and exhibited acute kidney injury (AKI). Serum creatinine and creatine kinase (CK) levels were increased to maximal values of 6.16 mg/dL and 18,963 U/L, respectively. Blood flow signals were not detected on kidney Doppler ultrasound. We considered that AKI was caused by blood flow impairment and capillary leak syndrome due to DCI in addition to rhabdomyolysis secondary to arterial gas embolism in the skeletal muscles. Temporary dialysis was required to correct the acidemia and electrolyte disturbance. Diuretic phase was initiated, and the patient was put off dialysis on day 3. Serum creatinine and CK levels returned to normal on day 11. He was successfully treated without any complications. Although AKI is a rare manifestation, we should consider AKI risk in patients with severe DCI.

Keywords

Acute kidney injury Arterial gas embolism Decompression illness Decompression sickness 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest associated with this manuscript.

Human and animal rights

The article does not contain studies with human or animal participants.

Informed consent

Informed consent was obtained from the patient.

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Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  • Arata Hibi
    • 1
    Email author
  • Keisuke Kamiya
    • 1
  • Takahisa Kasugai
    • 1
  • Keisuke Kamiya
    • 2
  • Satoru Kominato
    • 1
  • Chiharu Ito
    • 1
  • Toshiyuki Miura
    • 1
  • Katsushi Koyama
    • 1
  1. 1.Division of Nephrology and Rheumatology, Department of Internal MedicineKariya Toyota General HospitalKariyaJapan
  2. 2.Division of Nephrology and Rheumatology, Department of Internal MedicineAichi Medical University HospitalNagakuteJapan

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