Rhabdomyolysis-Associated Acute Kidney Injury With Normal Creatine Phosphokinase

Kamal, Faisal; Snook, Lindsay; Saikumar, Jagannath

doi:10.1016/j.amjms.2017.04.014

Cited by 9 publications

(9 citation statements)

References 18 publications

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“…6 A recently reported case of a patient that had used recreational drugs demonstrated little correlation between CK level and AKI. 2 CK levels do not appear to predict the long-term outcome of renal dysfunction, as demonstrated in the present case and in a previously reported case. 5 Both patients regained full renal function after haemodialysis even when they initially presented with extremely high levels of CK (300 000 or 650 000 U/l).…”

Section: Discussioncontrasting

confidence: 56%

“…For example, a recent case study described a 32-year-old man, diagnosed with rhabdomyolysis and acute kidney injury (AKI), whose CK level was normal (156 U/l). 2 Renal biopsy of this patient also confirmed severe acute tubular injuries with positive myoglobin casts. 2 The present case report describes a similar patient that experienced initial severe rhabdomyolysis (CK 300 000 U/l), who subsequently regained full renal function following haemodialysis.…”

Section: Introductionsupporting

confidence: 56%

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A patient with severe rhabdomyolysis and high levels of creatinine kinase had renal functions fully recovered after haemodialysis: a case report

Tsai

Chen

2019

J Int Med Res

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Rhabdomyolysis is diagnosed based on the levels of blood biomarkers such as creatine kinase (CK), but the use of CK levels to predict long-term renal function remains controversial. This current report presents a case with a very high CK level with the presentation of acute kidney injury (AKI) who regained full renal function. A 29-year-old man, in a manic mood and presenting with dyspnoea, was admitted to hospital following an episode of ketamine use along with a history of drug abuse. The laboratory analyses identified rhabdomyolysis (CK, 35 266 U/l) and AKI (serum creatinine, 3.96 mg/dl). Despite treatment with intravenous normal saline (4000 ml/day), his CK level reached at least 300 000 U/l. He underwent 13 sessions of haemodialysis and his renal function fully recovered. The final measurements were serum creatinine 1.0 mg/dl and CK 212 U/l. These findings support the view that the predictive power of CK level on AKI is limited, especially regarding long-term renal function. Close follow-up examinations of renal function after haemodialysis are mandatory for patients with rhabdomyolysis.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionsupporting

confidence: 56%

A patient with severe rhabdomyolysis and high levels of creatinine kinase had renal functions fully recovered after haemodialysis: a case report

Tsai

Chen

2019

J Int Med Res

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“…Another possibility is rhabdomyolysis without elevated CK. A prior case report showed that CK alone might not be a sensitive marker for diagnosing rhabdomyolysis [17]. Despite confirmatory myoglobin casts on renal biopsy in that case, the patient’s CK concentration was only 156 U/L.…”

Section: Discussionmentioning

confidence: 81%

Caffeine Overdose Complicated by Acute Kidney Injury despite Mild Creatine Kinase Elevation

et al. 2020

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Caffeine is a commonly used stimulant in our society. Prior case reports have described acute caffeine overdose resulting in rhabdomyolysis and acute kidney injury (AKI). We present the case of a 29-year-old man who presented to the emergency department after ingesting 20.1 g of caffeine in a suicide attempt and experienced AKI with only mildly elevated creatine kinase (CK). This case highlights the possibility that AKI can result from a caffeine overdose, even if the patient's CK is only slightly elevated.

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“…Although the pathogenesis of RM-associated ATN may correlate more closely with plasma myoglobin levels, it is seldom used in making a diagnosis because it returns to normal serum values within six to eight hours or at the time of presentation, due to a shorter half-life of two to three hours and quicker metabolism by the liver. Because serum CK has a longer half-life of about 36 hours, a five-fold rise in serum CK levels from baseline is diagnostic for RM [5]. Serum CK levels are also used in RM cases to predict the risk of progression to AKI.…”

Section: Discussionmentioning

confidence: 99%

“…RM comprises about 7%-10% of cases of AKI in the form of ATN, while approximately 13%-50% of cases of RM, if not diagnosed and treated earlier, go on to develop AKI [4,5]. So the early diagnosis of RM can prevent the progression to AKI.…”

Section: Introductionmentioning

confidence: 99%

A Late Presentation of Substance-related Rhabdomyolysis with Normal Serum Creatine Kinase Levels and Complicated with Acute Tubular Necrosis

Ahmad

Zain

Ashfaq

et al. 2019

Cureus

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Substance abusers are at increased risk of acute kidney injury (AKI) compared to the general population due to nontraumatic rhabdomyolysis. The primary target of these nephrotoxic agents is the tubulointerstitial compartment and the most frequent findings on biopsy are consistent with acute tubular necrosis (ATN) and acute interstitial nephritis. We present a rare case of an intravenous cocaine and heroin abuser who presented with recent onset oliguria, hematuria, and reduced peroral intake. The urine dipstick testing showed guaiac positivity but no red blood cells on microscopy. The blood workup showed elevated serum creatinine and urea levels but normal creatinine kinase (CK) level. Renal biopsy showed tubular epithelial cell necrosis and positive immunoperoxidase staining for myoglobin pigment casts in renal tubules. The diagnosis of rhabdomyolysis-associated ATN secondary to substance abuse was suggested. However, normal serum CK levels as well as urine drug panel supported the delayed presentation of rhabdomyolysis complicated with ATN. The patient returned to normal health with no residual kidney dysfunction after undergoing temporary hemofiltration.

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Rhabdomyolysis-Associated Acute Kidney Injury With Normal Creatine Phosphokinase

Cited by 9 publications

References 18 publications

A patient with severe rhabdomyolysis and high levels of creatinine kinase had renal functions fully recovered after haemodialysis: a case report

A patient with severe rhabdomyolysis and high levels of creatinine kinase had renal functions fully recovered after haemodialysis: a case report

Caffeine Overdose Complicated by Acute Kidney Injury despite Mild Creatine Kinase Elevation

A Late Presentation of Substance-related Rhabdomyolysis with Normal Serum Creatine Kinase Levels and Complicated with Acute Tubular Necrosis

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