A Case Report of a Patient with Delusional Water Refusal Leading to Chronic Kidney Injury
Abstract
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.
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BibTeX
@article{anasibnauf2026case,
title = {{A Case Report of a Patient with Delusional Water Refusal Leading to Chronic Kidney Injury}},
author = {Anas Ibn Auf, M.B.B.S., M.Sc., M.D. and Muath Mohammed Alqarni, M.B.B.S. and Rami Abdulla Aljuaid, M.B.B.S.},
journal = {Taiwanese Journal of Psychiatry},
year = {2026},
month = jul,
doi = {10.4103/tpsy.tpsy_33_26},
url = {https://doi.org/10.4103/tpsy.tpsy_33_26},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A Case Report of a Patient with Delusional Water Refusal Leading to Chronic Kidney Injury
AU - Anas Ibn Auf, M.B.B.S., M.Sc., M.D.
AU - Muath Mohammed Alqarni, M.B.B.S.
AU - Rami Abdulla Aljuaid, M.B.B.S.
PY - 2026
DA - 2026/07/01
JO - Taiwanese Journal of Psychiatry
DO - 10.4103/tpsy.tpsy_33_26
UR - https://doi.org/10.4103/tpsy.tpsy_33_26
AB - 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.
SN - 1028-3684
SN - 2666-2078
ER -