We present the case of a young male with 2-month history of intermitte
nt upper abdominal pain who developed diarrhea, anorexia, tea-color ur
ine, and decreased urine output. He was found to be in severe acute re
nal failure requiring hemodialysis, four sessions in 10-day period. By
the end of the second week of hospitalization renal function graduall
y improved with total recovery of function to a baseline creatinine of
1.1 mg/dl 25 days after the diagnosis of acute renal failure. His wor
kup included Ham's test, water sugar test, and RBC fragility test whic
h confirmed the diagnosis of paroxysmal nocturnal hemoglobinuria.