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Acute renal failure is defined as a rapid decrease in the glomerular filtration rate, occurring over a period of hours to days and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. AKI is a catastrophic, life-threatening event in critically ill patients. AKI can be divided into pre-renal injury, intrinsic kidney disease (including vascular insults) and obstructive uropathies. The prognosis of AKI is highly dependent on the underlying cause of the injury. Children who have AKI as a component of multisystem failure have a much higher mortality rate than children with intrinsic renal disease. Treatment of AKI is subjected to risk stratification and ongoing damage control measures, such as patients with sepsis, exposure to nephrotoxic agents, ischemia, bloody diarrhea, or volume loss, could be helped by optimizing the fluid administrations, antibiotics possessing least nephrotoxic potential, blood transfusion where hemoglobin is dangerously low, limiting the use of nephrotoxic agents including radio contrast use, while maximize the nutrition. Acute kidney injury remains a complex disorder with an apparent differentiation in pathology between septic and nonseptic forms of the disease. Although more studies are still required, progress in this area has been steady over the last decade with purposeful international collaboration.

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Salmonella is primarily known to affect the gastrointestinal tract but can rarely cause infections at uncommon sites, such as the urinary tract. It is known that Salmonella can infect the urinary tract directly by blood, fecal contamination of urethra, urolithiasis, or secondary intraluminal ascending infection.Our patient is a 59-year-old female with a past medical history of nephrolithiasis and multiple urinary tract infections (UTI) who presented with altered mental status and sepsis complicated by Salmonella bacteremia and UTI. Urine and blood cultures revealed Salmonella species > 100,000 colony-forming units per milliliter (CFU/mL) and non-typhoidal Salmonella, respectively. During the course of her hospital admission, the patient was treated with multiple antibiotics.On further review, it was noted that the patient had presented to the emergency room (ER) about four months earlier with abdominal pain and watery diarrhea with a stool culture being positive for nontyphoidal Salmonella.Gastroenteritis, sepsis, and enteric fever are normally known with Salmonella enterica serotype Typhi (S. Typhi). Less common extraintestinal diseases like UTI are due to non-typhoidal Salmonella. The most frequent pathogenesis of Salmonella UTI is probably hematogenous. UTI caused by non-typhoidal Salmonella is usually associated with structural abnormalities of the urinary tract. In our case, the patient had non-typhoidal Salmonella gastroenteritis followed by non-typhoidal Salmonella bacteremia and UTI.

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