Rhabdomyolysis and myoglobinuric renal failure

1990 ◽  
Vol 10 (3) ◽  
pp. 32-36 ◽  
Author(s):  
J Harper
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Patient Population ◽  
Clinical Syndrome ◽  
Skeletal Muscle Cell ◽  
Critical Care Nurses ◽  
Precipitating Factors ◽  
Optimal Function

Rhabdomyolysis, a clinical syndrome resulting from the release of skeletal muscle cell contents into the plasma, is causally connected to up to 25 percent of all cases of acute renal failure. Critical care nurses need to be aware of precipitating factors and proper interventions in order to assure optimal function in this patient population.

scholarly journals Rhabdomyolysis-Induced Acute Renal Failure Following Fenofibrate Therapy: A Case Report and Literature Review

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Ramazan Danis ◽  
Sami Akbulut ◽  
Sehmus Ozmen ◽  
Senay Arikan
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Metabolic Disorders ◽  
Cell Damage ◽  
Pathological Condition ◽  
Skeletal Muscle Cell ◽  
Fibric Acid Derivative ◽  
Alcohol And Drug Use ◽  
Laboratory Examinations

Fenofibrate, a fibric acid derivative, is used to treat diabetic dyslipidemia, hypertriglyceridemia, and combined hyperlipidemia, administered alone or in combination with statins. Rhabdomyolysis is defined as a pathological condition involving skeletal muscle cell damage leading to the release of toxic intracellular material into circulation. Its major causes include muscle compression or overexertion; trauma; ischemia; toxins; cocaine, alcohol, and drug use; metabolic disorders; infections. However, rhabdomyolysis associated with fenofibrate is extremely rare. Herein we report a 45-year-old female patient who was referred to our department because of generalized muscle pain, fatigue, weakness, and oliguria over the preceding 3 weeks. On the basis of the pathogenesis and clinical and laboratory examinations, a diagnosis of acute renal failure secondary to fenofibrate-induced rhabdomyolysis was made. Weekly followups for patients who are administered fenofibrate are the most important way to prevent possible complications.

Plasma and Skeletal Muscle Free Aminoacids in Acute Renal Failure

1987 ◽  
pp. 93-98
Author(s):  
Almerico Novarini ◽  
Isabella Simoni ◽  
Rossana Colla ◽  
Antonio Trifirò ◽  
Achille Guariglia ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Free Aminoacids

Morbidity and mortality of acute renal failure in the Critical Care Unit of a regional hospital

2018 ◽  
Vol 65 (6) ◽  
pp. 314-322
Author(s):  
M.E. Esteban Ciriano ◽  
J.M. Peña Porta ◽  
C. Vicente de Vera Floristán ◽  
S. Olagorta García ◽  
R. Álvarez Lipe ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Critical Care Unit ◽  
Regional Hospital ◽  
Morbidity And Mortality

Alcohol Related Non-traumatic Rhabdomyolysis and Compartment Syndrome

2007 ◽  
Vol 6 (1) ◽  
pp. 33-34
Author(s):  
JPL Ong ◽  
◽  
LA Thomas ◽  
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Lower Extremity ◽  
Compartment Syndrome ◽  
Early Recognition ◽  
Clinical Entity ◽  
Threatening Condition ◽  
Life Threatening ◽  
Renal Support

Rhabdomyolysis is a serious and life-threatening condition in which skeletal muscle is damaged, commonly resulting in acute renal failure. The causes of this clinical entity can be traumatic and non-traumatic. In the latter group, alcohol is the commonest cause. This report describes the case of a 25 year old man who presented with rhabdomyolysis leading to acute renal failure after an alcohol binge. He presented with painful legs and lower extremity compartment syndrome. The patient recovered with surgical fasciotomy and renal support. This case illustrates the importance of early recognition and treatment of alcohol related non-traumatic rhabdomyolysis and compartment syndrome.

Acute Tubular Necrosis: Diagnosis, Treatment, and Nursing Implications

1992 ◽  
Vol 3 (3) ◽  
pp. 688-697
Author(s):  
Sara Douglas
Keyword(s):  
At Risk ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Acute Tubular Necrosis ◽  
Early Recognition ◽  
Recovery Phase ◽  
Vital Role ◽  
Laboratory Findings ◽  
Tubular Necrosis

Acute tubular necrosis (ATN) is the most common cause of acute renal failure. Early recognition of patients who are at risk for ATN can prevent or improve the course of ATN. Acute renal failure is classified as prerenal, intrinsic, or postrenal disease. ATN is classified as a type of intrinsic renal disease. The clinical course of ATN is divided into the renal failure phase, diuretic phase, and recovery phase, with each phase having distinct symptoms and laboratory findings. Diagnosis of ATN often is complicated and confusing; understanding of laboratory findings can facilitate the critical care nurse’s ability to assess those at risk for ATN. The care and treatment of the patient with ATN is complicated, and specific treatments are discussed in detail. The critical care nurse can play a vital role in identifying the patient at risk, preventing the development of ATN in those at risk, and providing appropriate care for those who develop ATN

Enhanced skeletal muscle arteriolar reactivity to ANG II after recovery from ischemic acute renal failure

2005 ◽  
Vol 289 (6) ◽  
pp. R1770-R1776 ◽  
Author(s):  
David P. Basile ◽  
Deborah L. Donohoe ◽  
Shane A. Phillips ◽  
Jefferson C. Frisbee
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Pressor Response ◽  
Gracilis Muscle ◽  
Ang Ii ◽  
Sprague Dawley

In addition to the long-term renal complications, previous studies suggested that after acute renal failure (ARF), rats manifest an increased pressor response to an overnight infusion of ANG II. The present study tested whether recovery from ARF results in alterations in sensitivity to the peripheral vasculature. ARF was induced in Sprague-Dawley rats by 45 min of bilateral renal ischemia and reperfusion. Animals were allowed to recover renal structure and function for 5–8 wk, after which the acute pressor responses to ANG II were evaluated either in vivo in in situ skeletal muscle arterioles or in isolated gracilis muscle arteries in vitro. Baseline arterial pressure was not different in ARF rats vs. sham-operated controls, although ARF rats exhibited an enhanced pressor response to bolus ANG II infusion compared with control rats. Steady-state plasma ANG II concentration and plasma renin activity were similar between ARF and control rats. Constrictor reactivity of in situ cremasteric arterioles from ARF rats was enhanced in response to increasing concentrations of ANG II; however, no difference was observed in arteriolar responses to elevated Po2, norepinephrine, acetylcholine, or sodium nitroprusside. Isolated gracilis muscle arteries from ARF rats also showed increased vasoconstriction in response to ANG II but not norepinephrine. In conclusion, recovery from ischemic ARF is not associated with hypertension but is associated with increased arteriolar constrictor reactivity to ANG II. Although the mechanisms of this altered responsiveness are unclear, such changes may relate, in part, to cardiovascular complications in patients with ARF and/or after renal transplant.

scholarly journals Pathophysiologic Features and Prevention of Human and Experimental Acute Tubular Necrosis

2001 ◽  
Vol 12 (suppl 1) ◽  
pp. S20-S32 ◽  
Author(s):  
NORBERT LAMEIRE ◽  
RAYMOND VANHOLDER
Keyword(s):  
Renal Failure ◽  
Clinical Trials ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Basic Research ◽  
Critical Care Units ◽  
Tubular Necrosis ◽  
Negative Results ◽  
Therapeutic Tools ◽  
Injured Kidney

Abstract.Acute renal failure (ARF) remains a common and potentially devastating disorder that affects as many as 5% of all hospitalized patients, with a higher prevalence in patients in critical care units. The focus of this article is on categorizing recent pathophysiologic and clinically relevant developments in the field. The vascular and tubular factors in the pathogenesis of ARF, together with the potential mechanisms of recovery and repair of the injured kidney, are discussed. A number of experimental and clinical interventions to prevent. ARF are summarized. Although the clinical treatment of these patients is still largely supportive and many recent clinical trials showed rather negative results, it is hoped that basic research will provide therapeutic tools to improve the grim prognosis of this disease in the future.

scholarly journals Compartment Syndrome as a Result of Systemic Capillary Leak Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kwadwo Kyeremanteng ◽  
Gianni D’Egidio ◽  
Cynthia Wan ◽  
Alan Baxter ◽  
Hans Rosenberg
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Compartment Syndrome ◽  
Single Case ◽  
Rare Complication ◽  
Clinical Syndrome ◽  
Capillary Leak Syndrome ◽  
Capillary Leak ◽  
Systemic Capillary Leak Syndrome ◽  
Fluid Extravasation

Objective. To describe a single case of Systemic Capillary Leak Syndrome (SCLS) with a rare complication of compartment syndrome.Patient. Our patient is a 57-year-old male, referred to our hospital due to polycythemia (hemoglobin (Hgb) of 220 g/L), hypotension, acute renal failure, and bilateral calf pain.Measurements and Main Results. The patient required bilateral forearm, thigh, and calf fasciotomies during his ICU stay and continuous renal replacement therapy was instituted following onset of acute renal failure and oliguria. Ongoing hemodynamic (Norepinephrine and Milrinone infusion) and respiratory (ventilator) support in the ICU was provided until resolution of intravascular fluid extravasation.Conclusions. SCLS is an extremely rare disorder characterized by unexplained episodic capillary hyperpermeability, which causes shift of volume and protein from the intravascular space to the interstitial space. Patients present with significant hypotension, hemoconcentration, hypovolemia, and oliguria. Severe edema results from leakage of fluid and proteins into tissue. The most important part of treatment is maintaining stable hemodynamics, ruling out other causes of shock and diligent monitoring for complications. Awareness of the clinical syndrome with the rare complication of compartment syndrome may help guide investigations and diagnoses of these critically ill patients.

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