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Acute renal failure in patients with rhabdomyolysis.

Agnieszka Szymczakiewicz-Multanowska, Dorota Szumilak, Andrzej Miłkowski, Wladyslaw Ochmański, Antoni Sydor, Boguslaw Walatek, Wladyslaw Sułowicz, Andrzej Kraśniak, Hanna Lonak, Tadeusz Wójcikiewicz

Med Sci Monit 2002; 8(1): CR24-27

ID: 420968

BACKGROUND: Rhabdomyolysis is a relatively rare, not always diagnosed causeof acute renal failure (ARF). This fact motivated us to present the results of ARF treatment in the courseof 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 basedon clinical manifestation and laboratory test results (CPK, GTP, GOT, LDH). RESULTS: The most frequentcause of rhabdomyolysis was alcoholic intoxication (41 patients), often accompanied by hypothermia (15patients) or trauma (30 patients). Isolated trauma was found in 30 patients, epileptic seizure in 5,and physical exercise in 1 case. In 17 patients, besides alcohol consumption, trauma or epileptic seizure,the use of tranquilizers, anticonvulsants, or narcotic drugs was additionally noted. 78 patients developedARF 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 serumurea and creatinine were observed, as well as a tendency to hyperkalemia. The treatment results and mortalityrate in our study group were primarily influenced by the patients' general condition at admission, aswell as the extent of organ damage caused by the primary etiological factor. Favorable treatment resultswere obtained especially in those patients who were hospitalized in a nephrological center, while theworst outcomes were noted in those patients dialyzed in intensive care units, most with multiple trauma.

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