Acute Kidney Injury Due to Cholera: A Case Series

Worldwide, an estimated 1.3 to 4 million people are affected by cholera every year. Cholera is an acute infectious disease caused by ingestion of food and water contaminated by Vibrio cholerae. The clinical course of cholera varies from mild diarrhea to severe complications such as hypokalemia, hyponatremia or hypernatremia, metabolic acidosis, and acute kidney injury. The disease can be fatal if timely treatment is not initiated. We discuss here, two cases who presented to our tertiary care hospital with history of pain abdomen and multiple episodes of watery diarrhea. Both cases later developed acute renal failure secondary to severe gastroenteritis. The aetiology of the gastroenteritis was later confirmed to be cholera. Both cases presented with history of profuse watery diarrhoea with vomiting, on admission signs of volume depletion in the form of sunken eyes, reduced skin turgor and capillary filling time > 3 seconds were observed in both the cases. There was history of consumption of sea food from the local street vendor, but no history of movement outside the place of residence within last one week prior to onset of symptoms. Laboratory investigations revealed raised haemoglobin, PCV, raised blood urea and serum creatinine, hyperkalaemia; and anion gap. Despite aggressive rehydration, both the cases developed acute kidney injury. Renal ischemia secondary to dehydration leading to acute tubular necrosis may have caused the acute kidney injury with elevated urea/creatinine levels in our patients. Both our patients were successfully managed by intravenous infusion of fluids, electrolytes, sodium bicarbonate and appropriate antibiotics, followed by hemodialysis. Both the cases were discharged without any further complications as they showed signs of recovery of renal function.