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Huerta-Alardin, Ana Laura; Varon, Joseph; Marik, Paul E.

doi:10.1186/cc2978

Cited by 668 publications

(309 citation statements)

References 124 publications

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“…The clinical spectrum ranges from asymptomatic elevation of serum creatine kinase concentration to acute kidney injury (AKI) and multiorgan failure. Major causes of rhabdomyolysis include trauma, exertion, hypoxia, infections, metabolic disorders, drug toxicity and other [1,2,3]. …”

Section: Introductionmentioning

confidence: 99%

High Cut-Off Renal Replacement Therapy for Removal of Myoglobin in Severe Rhabdomyolysis and Acute Kidney Injury: A Case Series

et al. 2013

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Background/Aim: Rhabdomyolysis is associated with the release of myoglobin into the circulation, promoting acute kidney injury (AKI). In severe rhabdomyolysis, dialysis-dependent AKI doubles mortality. Standard blood purification techniques have limited efficacy in removing myoglobin. We describe high cut-off (HCO) renal replacement therapy (RRT) as a novel approach for extracorporeal elimination of myoglobin in rhabdomyolysis-associated AKI. Methods: With an in vivo molecular cut-off at 45 kDa, HCO filters are effective in removing myoglobin (17.8 kDa). Clearances across standard and HCO filters using continuous or intermittent RRT are reviewed in a case series of 11 patients with severe rhabdomyolysis and dialysis-dependent AKI. Results: Median myoglobin clearance across standard high-flux filters was 3.3 (interquartile range 2.3–3.9) ml/min for sustained low-efficiency daily dialysis (SLEDD) batch hemodialysis (HD) and 3.7 (2.9–6.7) ml/min for conventional HD. Respective clearances using HCO filters (membrane surface area: 1.1 m²) were 21.7 (20.3–26.1) ml/min (SLEDD) and 44.2 (41.3–47.0) ml/min (HD). Corrected for filter size, up to 20-fold higher clearances were obtained using HCO filters, resulting in profound and sustained reduction of plasma myoglobin concentration. Conclusions: As a novel approach, HCO RRT allows for rapid and effective removal of myoglobin from the circulation. In light of the pathogenic role in AKI, reducing exposure of the kidney to myoglobin may improve renal recovery and patient outcome. Our data pave the way for prospective trials, addressing this issue.

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Section: Introductionmentioning

confidence: 99%

High Cut-Off Renal Replacement Therapy for Removal of Myoglobin in Severe Rhabdomyolysis and Acute Kidney Injury: A Case Series

et al. 2013

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“…Physical etiologies include trauma, arterial occlusion, overexertion, seizures, delirium tremens, electrical injury, and hyperthermia. Nonphysical triggers include metabolic syndromes, toxins/drugs, infections, electrolyte abnormalities, endocrinopathies, and autoimmune conditions 3. His history did not reveal any physical triggers.…”

Section: Discussionmentioning

confidence: 99%

Rifaximin as a rare cause of rhabdomyolysis in cirrhosis

Rezigh

Armenia

et al. 2018

Clinical Case Reports

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“…[2] Common causes of rhabdomyolysis include extreme physical exertion, extensive tissue injury, metabolic derangements, drugs, and toxins. [1][2][3] Interestingly, few case reports have suggested that some dietary weight loss supplements could predispose to rhabdomyolysis. [4][5][6] It is theorized that ingredients in these products are directly toxic to myocytes and also impair intracellular calcium homeostasis leading to myonecrosis, especially in the setting of concomitant exertion.…”

Section: Introductionmentioning

confidence: 99%

Severe non-exertional rhabdomyolysis from weight loss supplement in sickle cell trait: A perfect storm?

Olanipekun

Effoe

Adeogun

et al. 2018

CRIM

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Exertional rhabdomyolysis from sickle cell trait has been documented. Also, cases of rhabdomyolysis from the use of weight loss supplements in the setting of sickle cell trait and exertion have been described. However, the role of sickle cell trait in non-exertional rhabdomyolysis is not clear. We present a case of severe non-exertional rhabdomyolysis from weight loss supplement in a patient with sickle cell trait.A 45-year-old African American female with sickle cell trait presented to the emergency department with two days history of fatigue and mild breathlessness. She also reported diarrhea and vomiting for five days before presentation. She admitted to taking Garcinia cambogia (a dietary supplement) for weight loss one week prior to the onset of symptoms. She denied alcohol or drug use, rigorous physical activity or trauma.She was dehydrated on examination. Laboratory values revealed markedly elevated serum creatine phosphokinase (CPK) and creatinine levels. Garcinia cambogia was discontinued and she was hydrated with intravenous fluids. Her CPK and creatinine levels significantly trended down and she was discharged home with no apparent sequelae.Our patient had multiple episodes of diarrhea and vomiting likely from the use of Garcinia cambogia. We believe she suffered non-exertional rhabdomyolysis from dehydration in the setting of sickle cell trait. Though dietary weight loss supplements are marketed as generally safe, this case suggests otherwise. We emphasize that clinicians routinely inquire about use of these supplements and provide appropriate counseling to patients on the adverse effects, especially among those with sickle cell trait.

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Untitled

Cited by 668 publications

References 124 publications

High Cut-Off Renal Replacement Therapy for Removal of Myoglobin in Severe Rhabdomyolysis and Acute Kidney Injury: A Case Series

High Cut-Off Renal Replacement Therapy for Removal of Myoglobin in Severe Rhabdomyolysis and Acute Kidney Injury: A Case Series

Rifaximin as a rare cause of rhabdomyolysis in cirrhosis

Severe non-exertional rhabdomyolysis from weight loss supplement in sickle cell trait: A perfect storm?

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