Acute renal failure related to the crush syndrome: towards an era of seismo‐nephrology?

Vanholder, Raymond; Sever, Mehmet Şükrü; Erek, Ekrem; Lameire, Norbert

doi:10.1093/ndt/15.10.1517

Cited by 192 publications

(270 citation statements)

References 25 publications

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“…[17,18] The clinical diagnosis of rhabdomyolysis is established when CK increases five or more times above normal levels, with a suggestive clinical picture and without heart and/or cerebral injury. Serum CK levels were increased in both groups, but the difference was insignificant.…”

Section: Risk Factors For Development Of Arfmentioning

confidence: 99%

“…Because the most effective measure for the prevention of ARF induced by rhabdomyolysis is extracellular volume expansion with saline solution combined with sodium bicarbonate and mannitol. [18,19] It was observed that children have a prevalence of ARF almost three times higher than adults. Comparatively, children have a lower blood volume and smaller body surface, which might be related to a more severe clinical picture due to an increase concentration of the venom.…”

Section: Risk Factors For Development Of Arfmentioning

confidence: 99%

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Snakebite-Induced Acute Kidney Injury: Data from Southeast Anatolia

et al. 2008

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Renal failure is an important complication of snakebite and a major cause of mortality. We aimed to study the clinical profile of snake envenomation in Southeast Anatolia, Turkey, in an adult population. We retrospectively analyzed the records of 200 snakebite victims from 1998 to 2006 at the Dicle University School of Medicine, Diyarbakir, Turkey. Sixteen patients (8%) developed AKI (acute kidney injury). Of those, 25% required dialysis and 18% died. There was no difference between groups in age, arrival time to hospital, and hospital stay time. Both groups received similar hydration and therapy at admission. Disseminated intravascular coagulation (DIC) was observed in 25% of the AKI group and was significantly higher than the non-AKI group (7.1%; p = 0.014). There was no significant difference regarding hemoglobin, platelet levels, and prothrombin time at admission. The prevalence of thrombocytopenia (<150,000 K/ UL ) was 60% in the AKI group and 40% in the non-AKI group (p > 0.05). WBC count was significantly higher in the AKI group than in those without AKI (p = 0.001); serum albumin was significantly lower in the AKI group than in those without AKI (p = 0.013). AKI is an important complication of snakebite that may lead to mortality. Despite some troublesome aspects due to its retrospective design, this is a large series from Southeast Anatolia of Turkey in an adult population. Subjects with high WBC, low albumin, and DIC should be closely followed up for the development of AKI.

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Section: Risk Factors For Development Of Arfmentioning

confidence: 99%

Section: Risk Factors For Development Of Arfmentioning

confidence: 99%

Snakebite-Induced Acute Kidney Injury: Data from Southeast Anatolia

et al. 2008

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“…[1] The degree of rhabdomyolysis can manifest from a subclinical rise of creatinine kinase to acute renal failure (ARF). [2] The main pathophysiologic mechanisms of rhabdomyolysisinduced myoglobinuric ARF are renal vasoconstriction, intraluminal cast formation, and direct myoglobininduced cytotoxicity. [1,3] There is also increasing evidence indicating that reactive oxygen species (ROS) plays an important role in the pathogenesis of myoglobinuric ARF.…”

Section: Introductionmentioning

confidence: 99%

L-Carnitine Ameliorates Glycerol-Induced Myoglobinuric Acute Renal Failure in Rats

et al. 2009

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“…Rhabdomyolisis refers to disintegration of striad muscle, which results in the release of muscular cells constituents into the extracellular fluid and circulation 27 . The enzyme CK is ubiquitously present in striad muscle.…”

Section: Discussionmentioning

confidence: 99%

Peroneal nerve palsy due to compartment syndrome after facial plastic surgery

Godeiro-Júnior

Oliveira

Felı́cio

et al. 2007

Arq. Neuro-Psiquiatr.

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-A 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS) was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS) was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur.KEY WORDS: compartment syndrome, plastic surgery, rhytidoplasty, peroneal nerve.Paralisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da face RESUMO -Logo após ritidoplastia bilateral, um jovem de 25 anos apresentou agitação, necessitando uso de haloperidol. Algumas horas após, desenvolveu dor intensa em membros inferiores, e o diagnóstico de sín-drome neuroléptica maligna foi considerado. Mesmo com o tratamento para tal, persistiu com dor. Após 12 horas do início do quadro, foi realizado o diagnóstico de síndrome compartimental de membros inferiores e o jovem foi submetido a fasciotomia bilateral. Uma seqüência de eventos desencadeou esta sín-drome, já que sua ocorrência dificilmente seria justificada pela cirurgia facial e/ou posição do paciente durante o procedimento. O jovem apresentava previamente dor em membros inferiores aos exercícios, sugerindo a ocorrência de uma síndrome compartimental crônica. Ele fazia uso de anabolizantes e venlafaxina, não relatado no início do quadro, e a agitação poderia ser explicada por uma síndrome serotoninérgia desencadeada pela interação deste último medicamento e haloperidol. A rabdomiólise secundária a estes eventos causou edema e isquemia nos compartimentos anteriores de ambos os membros inferiores, levando a uma compressão secundária do nervo fibular. O caso em questão ilustra a importância do diagnósti-co precoce da síndrome compartimental pois, caso contrário, mesmo com fasciotomia, uma complicação permanente devido à compressão de nervos periféricos pode se estabelecer. PALAVRAS-CHAVE: síndrome compartimental, cirurgia plástica, ritidoplastia, nervo fibular. Compartment syndrome (CS) develops when pressure within closed osseofascial compartments increases, reducing capillary perfusion gradient, leading to cellular anoxia and ...

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Acute renal failure related to the crush syndrome: towards an era of seismo‐nephrology?

Cited by 192 publications

References 25 publications

Snakebite-Induced Acute Kidney Injury: Data from Southeast Anatolia

Snakebite-Induced Acute Kidney Injury: Data from Southeast Anatolia

L-Carnitine Ameliorates Glycerol-Induced Myoglobinuric Acute Renal Failure in Rats

Peroneal nerve palsy due to compartment syndrome after facial plastic surgery

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