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Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis

Received: 8 May 2018     Accepted: 14 June 2018     Published: 24 July 2018
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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.

Published in American Journal of Internal Medicine (Volume 6, Issue 4)
DOI 10.11648/j.ajim.20180604.13
Page(s) 61-65
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Rhabdomyolysis, Acute Kidney Injury, Muscle Aches, Muscular Weakness

References
[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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  • APA Style

    Zongchao Yu, Bo Hu, Baozhang Guang, Taksui Wong, Wenyu Gong, et al. (2018). Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis. American Journal of Internal Medicine, 6(4), 61-65. https://doi.org/10.11648/j.ajim.20180604.13

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    ACS Style

    Zongchao Yu; Bo Hu; Baozhang Guang; Taksui Wong; Wenyu Gong, et al. Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis. Am. J. Intern. Med. 2018, 6(4), 61-65. doi: 10.11648/j.ajim.20180604.13

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    AMA Style

    Zongchao Yu, Bo Hu, Baozhang Guang, Taksui Wong, Wenyu Gong, et al. Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis. Am J Intern Med. 2018;6(4):61-65. doi: 10.11648/j.ajim.20180604.13

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  • @article{10.11648/j.ajim.20180604.13,
      author = {Zongchao Yu and Bo Hu and Baozhang Guang and Taksui Wong and Wenyu Gong and Wenxue Liang and Yunyi Li and Wolfgang Pommer and Berthold Hocher and Yongpin Lu and Chen Yun and Shufei Zeng and Fanna Liu and Lianghong Yin},
      title = {Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis},
      journal = {American Journal of Internal Medicine},
      volume = {6},
      number = {4},
      pages = {61-65},
      doi = {10.11648/j.ajim.20180604.13},
      url = {https://doi.org/10.11648/j.ajim.20180604.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20180604.13},
      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.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Causes, Clinical Features and Treatment of Rhabdomyolysis: A Retrospective Analysis
    AU  - Zongchao Yu
    AU  - Bo Hu
    AU  - Baozhang Guang
    AU  - Taksui Wong
    AU  - Wenyu Gong
    AU  - Wenxue Liang
    AU  - Yunyi Li
    AU  - Wolfgang Pommer
    AU  - Berthold Hocher
    AU  - Yongpin Lu
    AU  - Chen Yun
    AU  - Shufei Zeng
    AU  - Fanna Liu
    AU  - Lianghong Yin
    Y1  - 2018/07/24
    PY  - 2018
    N1  - https://doi.org/10.11648/j.ajim.20180604.13
    DO  - 10.11648/j.ajim.20180604.13
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 61
    EP  - 65
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20180604.13
    AB  - 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.
    VL  - 6
    IS  - 4
    ER  - 

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Author Information
  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • KfH Dialysis and Kidney Transplantation Committee, Neu-Isenburg, Germany

  • Department of Nephrology, Berlin Chatite University, Berlin, Germany

  • Department of Nephrology, Berlin Chatite University, Berlin, Germany

  • Department of Nephrology, Berlin Chatite University, Berlin, Germany

  • Department of Nephrology, Berlin Chatite University, Berlin, Germany

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China

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