A 30-year-old hypertensive male victim of a road traffic accident was admitted with a pelvic fracture. He had been on angiotensin receptor blockers (ARB). An external fixator was applied the same day. The following day he suffered a massive pulmonary embolism requiring thrombolysis. He started becoming oliguric. On the fourth day, he developed retroperitoneal hemorrhage with an intra-abdominal pressure of 22 mmHg, as a complication of anticoagulation. He required surgical drainage. After returning from the operation theater, he became anuric and his renal parameters deteriorated. He had developed acute kidney injury and had to be commenced on renal replacement therapy.