A Case Report of a Patient with Delusional Water Refusal Leading to Chronic Kidney Injury
Anas Ibn Auf, Muath Mohammed Alqarni, Rami Abdulla AljuaidAbstract
Background:
Delusional water refusal is a rare but clinically significant behavioral manifestation in schizophrenia. Unlike psychogenic polydipsia, reduced water intake is rare and can lead to chronic dehydration and renal impairment.
Case Report:
A 65-year-old male long-standing patient with schizophrenia and a prolonged inpatient stay, was found to have persistently elevated creatinine levels (86–178 µmol/L) over six years with no clear medical cause. The result of an imaging study showed that the cortex of his left kidney was thin. A fluid intake chart revealed complete avoidance of drinking clear water. Further psychiatric evaluation revealed a fixed religious delusion resulting in his water intake avoidance.
Conclusion:
This is case report highlights a rare presentation of delusional water avoidance contributing to chronic renal impairment. Routine assessment of hydration behaviors is essential when treating unexplained renal abnormalities in patients with severe mental illness.