Abstract
The presence of acute kidney injuries (AKIs) in adults with microangiopathic hemolytic anemia and thrombocytopenia poses diagnostic and therapeutic challenges, as there are numerous causes that cannot always be rapidly differentiated. Treatment options vary widely, ranging from urgent treatments such as plasma exchange and anticomplement therapy to observation and supportive care. We report a case of AKI secondary to hypertension-related thrombotic microangiopathy and describe the clinical course from presentation to diagnosis and treatment. The patient remained hemodialysis-dependent despite attempts to control the blood pressure and administer anticomplement treatment.