Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 12 3 2023 06 22 "Double whammy" to the kidneys: an unusual etiology of acute kidney disease e17252 e17252 10.34172/jnp.2022.17252 EN Varadharajan Jayaprakash https://orcid.org/0000-0002-6886-9015 Muthukaruppaiah Suganya https://orcid.org/0000-0002-7414-3210 Dhanasekaran Karthick https://orcid.org/0000-0002-1605-3364 Anila Abraham Kurien https://orcid.org/0000-0002-4548-8623 Raghavan Padmanabhan Journal Article 10.34172/jnp.2022.17252 2021 07 11 2021 10 28 Severe rhabdomyolysis could lead to myoglobinuria and acute kidney injury (AKI). Acute interstitial nephritis (AIN) is commonly caused by drugs. AIN per se can cause ‘severe’ AKI. Renal recovery is delayed when several factors are involved in the pathogenesis of AKI. Survivors of AKI require long-term follow-up. Here, we report a case where both severe rhabdomyolysis and drug-induced AIN contributed to ‘severe’ dialysis-requiring AKI. Renal biopsy was diagnostic and showed characteristic features. Steroid therapy for AIN resulted in partial recovery.