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Acute renal failure in patients with rhabdomyolysis.
Med. Sci. Monitor 2002: 8 (1) s.CR24-CR27, tab., bibliogr. 27 poz.
Hasła klasyfikacyjne GBL:
dorośli 19-44 r.ż.
dorośli 45-64 r.ż.
dorośli = 65 r.ż.
Background: Rhabdomyolysis is a relatively rare, not alwayd diagnosed causes of acute renal failue (ARF). This fact motivated us to present the results of ARF treatment in the course of this polyetiological clinical syndrome. Material/Methods: The analysis was performed on 84 patients (6 F, 78 M) ranging in age from 18 to 82 years (mean 46.5), in whom rhabdomyolysis was diagnosed based on clinical manifestation and laboratory test results (CPK, GTP, GOT, LDH). Results: The most frequent cause of rhabdomyolysis was alcoholic intoxication (41 patients), often accompanied by hypothermia (15 patients) or trauma (30 patients) isoalted trauma was found in 30 patients, epileptic seizure in 5, and physical exercise in 1 case. In 17 patients, besides alkohol consumption, trauma or epileptic seizure, the use of tranquilizers, anticonvulsants, or narcotic drugs was additonally noted. 78 patients developed ARF requiring dialysis therapy; 49 patients recovered, 5 required maintenance dialysis, and 30 died. Conclusions: During the initial phase of ARF in the course of rhabdomyolysis dynamic increases in serum urea and creatinine were observed, as well as a tendency to hyperkalemia. The treatment results and mortality rate in our study group were primarily influenced by the patients' general condition at admisssion, as well as the extent of organ damage caused by the primary etiological factor. Favorable treatment results were obtained especially in those patients who were hospitalized in a nephrological center, while the worst outcomes were noted in those patients dialyzed in intensive care units, most with multiple trauma.
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