ICU Cases · AKI & RRT
Acute kidney injury from rhabdomyolysis — the pigment nephropathy
A short case on rhabdomyolysis-associated acute kidney injury — recognition from CK, metabolic complications, and early aggressive crystalloid replacement.
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Prompt
A 41-year-old man is brought to the emergency department after being found unconscious at home for an uncertain time, lying on a hard floor. He is oliguric, his urine is dark, and his creatine kinase is markedly elevated.
Presentation
A 41-year-old man is found after lying unconscious on a hard floor for an uncertain period. He has swollen, tender thighs, dark urine and oliguria. Creatine kinase is 48,000 U/L, creatinine 210 micromol/L, potassium 6.4 mmol/L and venous pH 7.28.[3]
References3ShowHide
- [1]Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International Supplements 2012; 2: 1–138, 2012.Source
- [2]Lindner G, Burdmann EA, Clase CM, et al. Acute hyperkalemia in the emergency department: a summary from a Kidney Disease: Improving Global Outcomes conference. European journal of emergency medicine : official journal of the European Society for Emergency Medicine, 2020.PMID 32852924
- [3]Cabral BMI, Edding SN, Portocarrero JP, et al. Rhabdomyolysis. Disease-a-month : DM, 2020.PMID 32532456