ABSTRACT
We present a case of a 49-year-old male with complaints of back pain and not being able to urinate. The patient was suffering from back pain for the last four days and followed up with the chiropractor, but the pain persisted. The patient took eight ibuprofen tablets (1600 mg) within those four days to relieve the pain. Lab workup showed a blood urea nitrogen (BUN) of 175 mg/dL, creatinine level of 32.87mg/dL, and an anion gap metabolic acidosis. With close monitoring and dialysis in the hospital, the creatinine came down to 11.92mg/dL. Ultrasound-guided renal biopsy showed that the patient developed acute interstitial nephritis. The patient was treated with prednisone and later discharged with a creatinine level of 8.60mg/dL. Before he was discharged, he was declared to have end-stage renal disease and placed on outpatient dialysis. Only a few case reports are recorded in the literature with such a high elevation of creatinine levels.