Abstract: SA-PO0042
Toxic Energy: A Case of Acute Tubular Injury After Moderate Energy Drink Consumption
Session Information
- AKI: Novel Patient Populations and Case Reports
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Aguilar, Fatima, Montefiore Einstein Medical Center, New York, New York, United States
- Parghi, Devam, Montefiore Einstein Medical Center, New York, New York, United States
- Gallippi, Valeria, NYC Health + Hospitals, New York, New York, United States
- Pullman, James M., Montefiore Einstein Medical Center, New York, New York, United States
- Coco, Maria, Montefiore Einstein Medical Center, New York, New York, United States
Introduction
While energy drinks are known to cause cardiovascular, neurological, and gastrointestinal side effects, only two case reports link them to acute kidney injury (AKI). We report a case of acute tubular injury in a healthy 32-year-old man after moderate energy drink consumption.
Case Description
The patient, who had no prior medical history, presented with nausea, vomiting, and diarrhea. He had consumed 1–2 12 oz energy drinks daily for the previous month while training for a physical endurance test. He denied other supplement or drug use. His admission labs were creatinine 15.8 mg/dL (up from 1.3 mg/dL the previous week), BUN 77 mg/dL, bicarbonate 15 mEq/L, potassium 6.1 mEq/L. Urinalysis showed proteinuria, no hematuria, and a urine protein-to-creatinine ratio of 1.8 mg/gm. Urine toxicology screen was negative. Renal ultrasound showed bilateral parenchymal disease without obstruction or stones.
Due to resistant hyperkalemia, hemodialysis was initiated. During the first session, the patient developed acute respiratory distress, likely due to flash pulmonary edema from uncontrolled hypertension, requiring ICU admission and mechanical ventilation. Kidney biopsy showed acute tubular injury with epithelial vacuolization, suggestive of nephrotoxicity from a drug or toxin. He was treated with continuous renal replacement therapy and then intermittent hemodialysis, ultimately followed by renal recovery and discharge.
Discussion
The two previous reports of AKI linked solely to energy drinks involved excessive intake (>5 cans/day), compared to the 1-2 cans consumed by this patient. Potentially toxic ingredients in his drinks include caffeine, guarana, taurine, and other herbal ingredients- marketed as antioxidants, such as green tea and ginseng extracts. Caffeine by itself has effects which might lead to AKI, including diuresis and vasoconstriction leading to dehydration and reduced kidney perfusion, as well as A2A adenosine receptor inhibition triggering oxidative stress. The other ingredients individually are not known to cause AKI but could in combination with each other or caffeine.
This case highlights the potential for energy drinks to cause acute tubular injury even at moderate intake levels and raises awareness of their underrecognized renal risks.