eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-10-09 9 12 725 729 10.12691/ajmcr-9-12-17 AJMCR202191217 article Nida Saleem nidasaa1968@gmail.com 1 Saima Bashir 1 Syed Nayer Mahmud 1 Muhammad Haneef 1 Nephrology Department, Shifa International Hospital, Islamabad, 00000, Pakistan We report a case of an elderly male patient, who presented with acute kidney injury on background of diabetic nephropathy, secondary to dapagliflozin induced acute tubulo-interstitial nephritis requiring hemodialysis sessions. Histopathological findings are consistent with moderate tubulo-interstitial inflammation with mixed lymphocytic and eosinophilic inflammatory deposits. The patient responded well to cessation of causative medication and upon initiation of high dose steroids. The direct cause and effect relationship between dapagliflozin initiation and development of acute tubulo-interstitial nephritis is indicative of dapagliflozin being responsible for marked renal deterioration, as seen in this patient. http://pubs.sciepub.com/ajmcr/9/12/17/ajmcr-9-12-17.pdf Acute interstitial nephritis (AIN) Diabetes dapagliflozin SGLT2 inhibitors acute kidney injury (AKI)