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Acute kidney injury caused by intravascular hemolysis after mechanical thrombectomy. Continuing Medical Education online Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. Medscape, LLC designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credits TM . Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To receive credit, please go to http://www.medscape.com/cme/ncp and complete the post-test. Learning objectivesUpon completion of this activity, participants should be able to: 1 Describe the clinical features of pulmonary embolism in a pregnant woman. 2 Describe the clinical features of intravascular hemolysis. 3 Describe the mechanism of action of the AngioJet ® . 4 Review the management of acute kidney injury associated with hemolysis. Competing interestsThe authors, the Journal Editor C Harman and the CME questions author D Lie declared no competing interests. THE CASEA 43-year-old African-American female (gravida 5 para 0), with an intrauterine pregnancy of 8 weeks' gestation, presented to the emergency room with crampy abdominal pain, shortness of breath, and shoulder pain. The patient's medical history was notable for hypertension, uterine fibroids, one spontaneous abortion in the first trimester, and three elective therapeutic abortions. She was not taking any prescription medications and had no known drug allergies. The patient's history also indicated that she had smoked one pack of cigarettes per week for 25 years, but she denied alcohol or illicit drug use. On physical examination, the patient's temperature was 36.0 °C, and she had a pulse rate of 118 beats per minute and a blood pressure of 142/87 mmHg. Oxygen saturation was 100% on a nonrebreather mask. The patient was alert S u M M a rYBackground A 43-year-old African-American female (gravida 5 para 0) with an 8-week intrauterine pregnancy presented to the emergency room with crampy abdominal pain, shortness of breath, and shoulder pain. She had normal renal function on admission. CT angiography of the chest revealed bilateral pulmonary emboli; therefore, the AngioJet® (Possis Medical, Inc., Minneapolis, MN) device was used to perform mechanical thrombolysis. The patient subsequently developed hyperkalemia, red urine and anuria.