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We report on a 44-year-old man with paroxysmal nocturnal hemoglobinuria, who developed renal hemosiderosis, interstitial nephritis, and chronic renal failure. Classically, it is assumed that the renal function is only uncommonly affected by this pathology. In most instances the renal hemosiderosis is an incidental finding at postmortem examination. In our case the presence of iron in the kidney, as confirmed by CT scan, magnetic resonance imaging and renal biopsy, occurred concomitantly with the development of renal insufficiency. A direct nephrotoxic effect of iron by the induction of highly reactive hydroxyl radicals is suggested.
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