Severe Rhabdomyolysis Complicated by Dialysis-Requiring Acute Kidney Injury and Acute Liver Injury: A Case Report

Severe rhabdomyolysis may cause life-threatening acute kidney injury and multiorgan dysfunction. A 63-year-old Malaysian man with coronary artery disease, recent percutaneous coronary intervention, hypertension and dyslipidaemia was admitted in September 2026 with rhabdomyolysis, acute kidney injury and acute liver injury with coagulopathy. Creatine kinase reached 59,267 U/L, and serum creatinine was 228 µmol/L on 1 September. Rosuvastatin-associated muscle toxicity was considered alongside occult infection and inflammatory causes, although drug causality was not established. The patient developed anuria and required eight renal replacement therapy sessions comprising conventional haemodialysis and sustained low-efficiency dialysis. His course was complicated by anaemia requiring transfusion and acute liver injury considered clinically consistent with ischaemic hepatitis. Urine output subsequently improved, with a polyuric phase documented from 28 September 26. He was discharged on 1 October 26 with nephrology follow-up; however, maintenance haemodialysis was required at follow-up on 21 October 26. Liver biochemistry had normalised by that visit. This case highlights the importance of investigating rhabdomyolysis systematically, managing severe kidney injury promptly and documenting longer-term renal outcomes.