Acute kidney injury associated with rhabdomyolysis in a patient with COVID-19

Jahnke, Viviane Schmitt; Poloni, José Antônio Tesser; Neves, Carla Andretta Moreira; Peter, Camila; Thompson, Claudia Elizabeth; Rotta, Liane Nanci

doi:10.1590/2175-8239-jbn-2020-0170

Cited by 1 publication

(2 citation statements)

References 12 publications

(23 reference statements)

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“…When the kidney filters the blood, the myoglobin goes along, and iron radicals are released from its catabolism. This iron can undergo the Fenton reaction in the kidney and produce reactive oxygen species, which are nephrotoxic, thus resulting in a direct tubular injury [9,12,13].…”

Section: Pathophysiologymentioning

confidence: 99%

“…The patient with RML may present with the oligo or asymptomatic form of the disease. When symptomatic, it shows symptoms such as myalgia, weakness, significant electrolyte disturbances, and increased muscle enzymes [4,9]. An elevation of at least five times the upper normal limit of CK levels is usually accepted for confirming the diagnosis of RML [10].…”

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Injury Due to Rhabdomyolysis: A Review of Pathophysiology, Causes, and Cases Reported in the Literature, 2011–2021

Da Silva Junior,

Neves Pinto,

Campelo Fraga

et al. 2023

Rev. Colomb. Nefrol.

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Introduction: Rhabdomyolysis (RML) is characterized by the destruction of muscle fibers and the release of intracellular constituents, with the potential to cause local and systemic complications, such as acute kidney injury (AKI). Methodology: Literature review in which articles were analyzed between 2011 and 2021, from the PubMed database. Results: RML can occur directly, indirectly, or secondary to trauma, metabolic disorders, medications and exogenous intoxication. Clinically, it may present asymptomatically, but a classic triad consisting of myalgia, generalized weakness and dark urine is common. AKI, despite being a late complication, is common. Laboratory markers used to diagnose RML are serum Creatine Kinase (CK) and serum and urinary Myoglobin, with CK being more sensitive. The approach can occur through classic strategies, such as hydration, diuretics, alkalinization and renal replacement therapy (RRT), but also through new strategies, such as iron chelators and antioxidants; anti-inflammatories and new extracorporeal blood filter. Discussion: Trauma was the most common etiology of AKI due to RML, with a minority of patients requiring RRT. Furthermore, it was found that COVID-19 infection did not result in major kidney complications. Strenuous exercise has been shown to be a rare etiology of AKI due to RML. Other less common causes were drug use/intoxication and metabolic diseases, the majority of which patients did not require RRT or had a favorable outcome. Conclusion: RML is a potentially serious condition, making it important to know its causes and management in order to reduce the chances of serious complications and to avoid patient death.

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Section: Pathophysiologymentioning

confidence: 99%