Renal Replacement Therapy in Acute Kidney Failure due to Rhabdomyolysis

Maggi, G.; Hinojosa, Fabiola Quinteros; Villagran, M. J.; Arévalo, E. Guasch; Rodríguez, Fernando

doi:10.1155/2012/603849

Cited by 5 publications

(5 citation statements)

References 19 publications

(24 reference statements)

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“…In the current study, the plasma myoglobin concentration was higher in A60 than in the A30 group, indicating A60 as a stronger rhabdomyolysis case. Acute renal injury appears as a complication of myoglobinuria in the setting of any trauma [57,58]. Rhabdomyolysis that is associated with the A60 group could contribute to the pathogenesis of AKI observed in our study.…”

Section: Plos Onementioning

confidence: 54%

Distal organ inflammation and injury after resuscitative endovascular balloon occlusion of the aorta in a porcine model of severe hemorrhagic shock

Dubick

Yang

et al. 2020

PLoS ONE

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Background and objective Resuscitative Endovascular Balloon Occlusion of Aorta (REBOA) has emerged as a potential life-saving maneuver for the management of non-compressible torso hemorrhage in trauma patients. Complete REBOA (cREBOA) is inherently associated with the burden of ischemia reperfusion injury (IRI) and organ dysfunction. However, the distal organ inflammation and its association with organ injury have been little investigated. This study was conducted to assess these adverse effects of cREBOA following massive hemorrhage in swine. Methods Spontaneously breathing and consciously sedated Sinclair pigs were subjected to exponential hemorrhage of 65% total blood volume over 60 minutes. Animals were randomized into 3 groups (n = 7): (1) Positive control (PC) received immediate transfusion of shed blood after hemorrhage, (2) 30min-cREBOA (A30) received Zone 1 cREBOA for 30 minutes, and (3) 60min-cREBOA (A60) given Zone 1 cREBOA for 60 minutes. The A30 and A60 groups were followed by resuscitation with shed blood post-cREBOA and observed for 4h. Metabolic and hemodynamic effects, coagulation parameters, inflammatory and end organ consequences were monitored and assessed. Results Compared with 30min-cREBOA, 60min-cREBOA resulted in (1) increased IL-6, TNF-α, and IL-1β in distal organs (kidney, jejunum, and liver) (p < 0.05) and decreased reduced glutathione in kidney and liver (p < 0.05), (2) leukopenia, neutropenia, and coagulopathy (p < 0.05), (3) blood pressure decline (p < 0.05), (4) metabolic acidosis and hyperkalemia (p < 0.05), and (5) histological injury of kidney and jejunum (p < 0.05) as well as higher levels of creatinine, AST, and ALT (p < 0.05). Conclusion 30min-cREBOA seems to be a feasible and effective adjunct in supporting central perfusion during severe hemorrhage. However, prolonged cREBOA (60min) adverse effects such as distal organ inflammation and injury must be taken into serious consideration.

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Section: Plos Onementioning

confidence: 54%

Distal organ inflammation and injury after resuscitative endovascular balloon occlusion of the aorta in a porcine model of severe hemorrhagic shock

Dubick

Yang

et al. 2020

PLoS ONE

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“…In patients with clinically relevant hyperkalemia (based on electrocardiographic indings) or with values greater than 6.5 mmol per liter; oliguria (less than 0.5 mL of urine per kilogram per hour for 12 hours); anuria; volume overload or resistant metabolic acidosis (pH < 7.1), renal replacement therapy should be considered for urgent removal of myoglobin from renal tubules. [31] In our case, we administered intravenous luids while monitoring strict urine output, respiratory rate, and oxygen requirements. We monitored serial serum creatinine and CPK levels.…”

Section: Discussionmentioning

confidence: 90%

COVID-19 related rhabdomyolysis

Munoz-Martinez¹,

Waheed²,

Jhaveri³

et al. 2020

J Clini Nephrol

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A novel coronavirus known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) with a high rate of human-to-human transmission has emerged, resulting in a worldwide public health crisis of catastrophic proportions. Common initial symptoms of Coronavirus Disease 2019 (COVID-19) include fever, cough, fatigue, myalgia, and shortness of breath. Complications include acute respiratory distress syndrome (ARDS), acute cardiac injury, acute kidney injury, and secondary infections [1,2]. There have been reports of patients infected with COVID-19 who either presented with muscle pain and rhabdomyolysis or developed muscle damage as a late complication during hospitalization [3-8].

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“…La presencia de lesión renal aguda con CQ elevada en pacientes con estatus epiléptico, indica sospechar como primera posibilidad RBM por lesión mecánica muscular propia de los eventos convulsivos. Sin embargo, en pacientes con adecuado manejo de estatus epiléptico que persistan con deterioro de la función renal y el aumento de la CQ más allá del quinto día de seguimiento, indica evaluar diagnósticos diferenciales de RBM, ya que el pico de aumento de la CQ se ha descrito ocurre hacia el tercer día de finalizado el evento desencadenante de RBM, así como su retorno a valores normales hacia el quinto día, manteniéndose o incluso acelerándose este comportamiento farmacocinético en pacientes con requerimiento de terapia de reemplazo renal (8,(17)(18)(19). Dentro de los diagnósticos diferenciales de RBM, debe considerarse la presencia de efecto adverso a medicamento, que, para el caso aquí descrito, fue el LEV el único medicamento recibido por el paciente con evidencia científica de RBM como potencial efecto adverso.…”

Section: Discussionunclassified

Rabdomiolisis por levetiracetam

2019

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Introducción: el levetiracetam (LEV) es un medicamento anticonvulsivo con mecanismo de acción desconocido. La mayoría de efectos adversos son de intensidad leve a moderada, siendo la rabdomiolisis (RBM) uno recientemente descrito, con pocos casos reportados en el mundo. Descripción del caso: hombre de 35 años, con antecedentes de obesidad y epilepsia generalizada sin tratamiento, quien cursa con estatus epiléptico, controlado con benzodiacepina y LEV satisfactoriamente. Examen neurológico y tomografía de cráneo simple descartan alteraciones asociadas. Presenta lesión renal aguda por RBM que a pesar de estatus epiléptico controlado y manejo con soporte dialítico, progresan hacia el deterioro. Se sospecha RBM por LEV luego de descartarse etiología autoinmune y RBM por inmovilización de paciente obeso. Se suspende el LEV observándose descenso rápido de la creatina quinasa (CQ) y mejoría progresiva de la lesión renal aguda, confirmándose así la sospecha diagnóstica. Se logra destete y retiro de soporte dialítico, dándose alta hospitalaria con función renal y CQ normales, ácido valproico como anticonvulsivante y alerta de contraindicación para manejo con LEV. Discusión: el LEV es un antiepiléptico cuyos efectos adversos más frecuentes son: somnolencia, mareo, irritabilidad, cefalea y fatiga. La RBM por LEV es un efecto adverso infrecuente (pocos casos reportados en el mundo y ninguno reportado en Colombia). La sociedad europea incluyó dentro de los rótulos del LEV este efecto adverso recientemente. Su tratamiento se basa en suspender el medicamento y administrar terapia de soporte, así como, seguimiento clínico estrecho. Conclusión: la RBM por LEV es un efecto adverso poco frecuente que debe sospecharse en presencia de lesión renal aguda por RBM sin otras causas explicables

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Renal Replacement Therapy in Acute Kidney Failure due to Rhabdomyolysis

Cited by 5 publications

References 19 publications

Distal organ inflammation and injury after resuscitative endovascular balloon occlusion of the aorta in a porcine model of severe hemorrhagic shock

Distal organ inflammation and injury after resuscitative endovascular balloon occlusion of the aorta in a porcine model of severe hemorrhagic shock

COVID-19 related rhabdomyolysis

Rabdomiolisis por levetiracetam

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