AKI and Electrolyte Disturbances in Migrants Crossing the Rio Grande: A Case Series

Introduction: The Rio Grande Valley is a major corridor for undocumented migration. Migrants endure prolonged travel with dehydration, heat exposure, and limited care. While AKI from exertion has been reported in Arizona, data from South Texas are limited. Case Description: Seven undocumented migrants were admitted to the internal medicine ward of a community hospital in Weslaco, Texas, after crossing the Rio Grande. All patients developed acute kidney injury. Etiologies included rhabdomyolysis, sepsis-associated injury, NSAID-related nephropathy, volume depletion, and acute-on-chronic kidney disease. Comorbidities among the patients included diabetes, hypertension, chronic kidney disease, and gout. Metabolic acidosis was present in six patients. Hyperkalemia and hypokalemia, each in three patients, and five had hyponatremia. None required dialysis, and all were discharged following supportive management and clinical improvement Discussion: Migrants presented with AKI and electrolyte disturbances from diverse causes, often affected more by migratory conditions, comorbidities, and health access, than by climate aloneCountry of origin, travel details, and clinical summaries Clinical and Laboratory Characteristics of patients - Case Sex Age Date of encounter Country of Origin Past Medical History Diagnosis Creatinine CK BUN Na Cl K CO2 1 Male 29 4/24/23 Mexico Gout + CKD AKI secondary to NSAIDS 3.4 N/A 43 134 97 4.9 20 2 Male 39 6/25/23 Guatemala None Rhabdomyolysis 7.7 63189 116 122 78 5.1 21 3 Female 40 8/28/23 Guatemala None ATN 14.7 198 85 136 98 2.7 15 4 Female 25 10/1/23 Colombia None AKI + Septic Shock secondary to UTI 1.13 71 13 135 100 2.8 19 5 Female 44 10/30/23 Honduras DM2+HTN+CKD IV+HF AKI on CKD + ADHF 5.51 100 84 130 108 6.5 10 6 Male 44 11/11/23 Guatemala Gout AKI secondary to dehydration 1.84 202 21 124 85 3.2 21 7 Female 68 6/28/24 Venezuela DM+HTN+CKD AKI + Sepsis 2.11 85 45 132 100 5.2 20 Abbreviations: AKI, acute kidney injury; ATN, acute tubular necrosis; CK, creatine kinase; Cr, creatinine; BUN, blood urea nitrogen; DM2, type 2 diabetes mellitus; HTN, hypertension; CKD, chronic kidney disease; HF, heart failure; ADHF, acute decompensated heart failure; UTI, urinary tract infection; N/A, not available. Laboratory values reflect measurements on hospital admission