Rhabdomyolysis and acute renal failure after strenuous exercise and alcohol abuse: case report and literature review

CONTEXT: Rhabdomyolysis is a severe and life- threatening condition in which skeletal muscle is damaged. Acute renal failure due to rhab- domyolysis has been widely described and its main pathophysiological mechanisms are renal vasoconstriction, intraluminal cast formation and direct myoglobin toxic...

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Detalles Bibliográficos
Autores: Daher, Elizabeth De Francesco, Silva Júnior, Geraldo Bezerra da, Brunetta, Denise Menezes, Pontes, Lícia Borges, Bezerra, Glaydcianne Pinheiro
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2005
País:Brasil
Institución:Associação Paulista de Medicina
Repositorio:São Paulo medical journal (Online)
Idioma:inglés
OAI Identifier:oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/2302
Acceso en línea:https://periodicosapm.emnuvens.com.br/spmj/article/view/2302
Access Level:acceso abierto
Palabra clave:Rabdomiólise
Insuficiência renal aguda
Síndromes de compartimento
Exercícios
Intoxicação por álcool
Rhabdomyolysis
Acute kidney failure
Compartment syndrome
Exercise
Alcoholic intoxication
Descripción
Sumario:CONTEXT: Rhabdomyolysis is a severe and life- threatening condition in which skeletal muscle is damaged. Acute renal failure due to rhab- domyolysis has been widely described and its main pathophysiological mechanisms are renal vasoconstriction, intraluminal cast formation and direct myoglobin toxicity. OBJECTIVE: To report on a case of acute renal failure (ARF) induced by rhabdomyolysis due to strenuous exercise and alcohol abuse and to de- scribe the pathophysiology of this type of ARF. CASE REPORT: A 39-year-old man arrived at the hospital emergency service with swollen legs and lower extremity compartment syndrome. He was oliguric and had serum creatinine and urea levels of 8.1 mg/dl and 195 mg/dl, respectively. The diagnosis of rhabdomyolysis was made through clinical and laboratory findings (creatine kinase activity of 26320 IU/l). The initial treatment consisted of fluid replacement and forced diuresis. The specific treatment for compartment syndrome, such as fasciotomy, was avoided in order to prevent infection. Partial recovery of re- nal function was recorded, after ten hemodialysis sessions. Complete recovery was observed after two months of follow-up.