Volume 6, Issue 4, July 2018, Page: 61-65
Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis
Zongchao Yu, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Bo Hu, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Baozhang Guang, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Taksui Wong, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Wenyu Gong, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Wenxue Liang, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Yunyi Li, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Wolfgang Pommer, KfH Dialysis and Kidney Transplantation Committee, Neu-Isenburg, Germany
Berthold Hocher, Department of Nephrology, Berlin Chatite University, Berlin, Germany
Yongpin Lu, Department of Nephrology, Berlin Chatite University, Berlin, Germany
Chen Yun, Department of Nephrology, Berlin Chatite University, Berlin, Germany
Shufei Zeng, Department of Nephrology, Berlin Chatite University, Berlin, Germany
Fanna Liu, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Lianghong Yin, Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
Received: May 8, 2018;       Accepted: Jun. 14, 2018;       Published: Jul. 24, 2018
DOI: 10.11648/j.ajim.20180604.13      View  717      Downloads  64
Abstract
Abstract: Background: RM is a condition of skeletal muscle breakdown which ranges from an asymptomatic illness with elevation in CK level to a life-threatening condition associated with extreme elevation in CK, electrolyte imbalance, AKI, and disseminated intravascular coagulation. In this study, the author analyzed the causes, clinical features, and treatments of RM. Methods: The study collected the records of 48 patients in the First Affiliated Hospital of Jinan University who were diagnosed RM from June 2012 to August 2016. By using SPSS to analyse the data, the study draw a clear chart about the distribution of patients’ age, etiologies and clinical symptoms respectively. The statistic analysis also reveals dramatically change on CK and other indicators after treatment. Results: A total of 48 patients were eligible for the study (mean age = 29.7 ± 12.3 years; 36 males and 12 females). Strenuous exercises and infections took the greatest percent amount the causes of RM. Muscular weakness and muscle aches were the two most common symptoms. Among the patients, 42 received intravenous (IV) fluid therapy, and none developed acute kidney injury (AKI). The other six patients accepted CRRT, five of whom had an alleviation of their symptoms. One patient was transferred to another hospital for further treatment since the primary disease was dermatomyositis and it was non-responsive to immunotherapy. Discussion and conclusions: RM is treatable if early diagnosis, comprehensive therapy, active prevention, and the timely elimination of complications are put into effect. Its main symptoms such as muscle aches, muscular weakness, and dark urine may not presented at the same time. In this study, Strenuous exercise is the most common cause of RM and IV fluid therapy is the cornerstone of RM treatment. CRRT should also be considered when life-threatening electrolyte abnormalities emerge as complications of AKI, or when the RM is non-responsive to initial therapy.
Keywords
Rhabdomyolysis, Acute Kidney Injury, Muscle Aches, Muscular Weakness
To cite this article
Zongchao Yu, Bo Hu, Baozhang Guang, Taksui Wong, Wenyu Gong, Wenxue Liang, Yunyi Li, Wolfgang Pommer, Berthold Hocher, Yongpin Lu, Chen Yun, Shufei Zeng, Fanna Liu, Lianghong Yin, Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis, American Journal of Internal Medicine. Vol. 6, No. 4, 2018, pp. 61-65. doi: 10.11648/j.ajim.20180604.13
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Fidan F, Alkan B, Uğurlu G, Boyraz E, Tosun A, Ardıçoğlu Ö, Akkuş S (2015). Spinning-induced rhabdomyolysis: A case report and review of literature. European Journal of Rheumatology 2: 37-38.
[2]
Huerta-Alardin AL, Varon J, Marik PE (2005). Bench-to-bedside review: Rhabdomyolysis - An overview for clinicians. Crit Care. 9: 158-69.
[3]
Bagley WH, Yang H, Shah KH. Rhabdomyolysis (2007). Intern Emerg Med 2: 210-8.
[4]
KDIGO AKI Work group (2012). KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl 2: 1-138.
[5]
Fardal H, Goransson LG (2016). Exercise-induced rhabdomyolysis - A new trend? Tidsskr Nor Laegeforen 136: 1537-41.
[6]
Culter TS, DeFilipps EM, Unterbrink ME, Evans AT (2016). Increasing incidence and unique clinical characteristics of spinning-induced rhabdomyolysis. Clin J Sport Med 26: 429-31.
[7]
Joshi D, Kumar N, Rai A. Dermatomyositis presenting with rhabdomyolysis and acute renal failure (2009): An uncommon manifestation. Annals of Indian Academy of Neurology 12: 45-47.
[8]
Petejova N, Martinek A (2014). Acute kidney injury due to rhabdomyolysis and renal replacement therapy: A critical review. Critical Care 18: 1-8.
[9]
Chavez LO, Leon M, Einav S, Varon J (2016). Beyond muscle destruction: A systematic review of rhabdomyolysis for clinical practice. Critical Care 20: 1-11.
[10]
Zimmerman JL, Shen MC (2013). Rhabdomyolysis. Chest. 144: 1058-65.
[11]
Cervellin G, Comelli I, Lippi G (2010). Rhabdomyolysis: Historical background, clinical, diagnostic and therapeutic features. Clin Chem Lab Med 48: 749-56.
[12]
Myburgh JA, Mythen MG (2013). Resuscitation fluids. N Engl J Med 369: 1243-1251.
[13]
Torres PA, Helmstetter JA, Kaye AM, Kaye AD (2015). Rhabdomyolysis: Pathogenesis, diagnosis, and treatment. The Ochsner Journal 15: 58-69.
[14]
Janga KC, Greenberg S, Oo P, Sharma K, Ahmed U. (2018). Nontraumatic exertional rhabdomyolysis leading to acute kidney injury in a sickle trait positive individual on renal biopsy. Case Rep Nephrol 3:1-5.
[15]
Sorrentino SA, Kielstein JT, Lukasz A, Sorrentino JN, Gohrbandt B, Haller H, Schmidt BM (2011). High permeability dialysis membrane allows effective removal of myoglobin in acute kidney injury resulting from rhabdomyolysis. Crit Care Med 39: 184-6.
[16]
Heyne N, Guthoff M, Krieger J, Haap M, Häring HU (2012). High cut-off renal replacement therapy for removal of myoglobin in severe rhabdomyolysis and acute kidney injury: A case series. Nephron Clin Pract 121: c159-c164.
[17]
Esposito P, Estienne L, Serpieri N, Ronchi D, Comi GP, Moggio M, Peverelli L, Bianzina S, Rampino T. (2018). Rhabdomyolysis-Associated Acute Kidney Injury. American Journal of Kidney Diseases. 71(6): A12-A14.
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