Biochemical investigation of suspected rhabdomyolysis

Beetham, Robert

doi:10.1258/0004563001899870

Cited by 92 publications

(75 citation statements)

References 40 publications

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“…It is commonly seen in trauma and electrical burns patients. To prevent morbidity and mortality from ARF due to rhabdomyolysis, early detection of ARF by monitoring the biochemical parameters such as serum creatinine, serum creatine kinase (CK), and urinary myoglobin (UM) can be helpful [2]. We performed this study in trauma and electrical burns patients to evaluate the use of these biochemical parameters for early prediction of highrisk patients who tend to develop ARF.…”

Section: Introductionmentioning

confidence: 99%

Utility of Serum Creatinine, Creatine Kinase and Urinary Myoglobin in Detecting Acute Renal Failure due to Rhabdomyolysis in Trauma and Electrical Burns Patients

Bhavsar

Rathod

et al. 2012

Indian J Surg

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Rhabdomyolysis due to trauma and burns is an important cause of acute renal failure (ARF) secondary to myoglobinuria. To prevent morbidity and mortality from ARF due to rhabdomyolysis, early detection of ARF by monitoring the biochemical parameters such as serum creatinine, serum creatine kinase (CK), and urinary myoglobin (UM) can be helpful. The aims of the study were (1) to detect ARF due to rhabdomyolysis using serum creatinine, serum CK, and UM in trauma and electrical burn patients (2) to compare utility of these parameters in early prediction of ARF in patients of rhabdomyolysis. A total of 50 patients with trauma and electrical burns were included in the study. Serum creatinine, serum CK, and UM measurements were done at the time of admission and after 48 h. Diagnosis of ARF was made in the patients by Rifle's criteria. The presence of significant elevation of creatinine, serum CK, and UM at the time of admission and after 48 h was compared in patients developing ARF by Fisher's exact test. Fifteen of the 50 patients developed ARF as per the defined criteria. Of these, 9 patients (60%) had raised level of serum creatinine above 1.4 mg% at admission and 14 patients (93.33%) had CK level >1250 U/L at admission, whereas UM was positive in 6 (40%) patients. Serum creatinine was significantly raised in all of the 15 ARF patients (100%) after 48 h of admission and serum CK was raised in 14 of the 15 ARF patients (93.33%). UM was negative in all the patients after 48 h of admission. Statistical analysis showed that rise in serum CK on admission was significantly increased in patients developing ARF as compared with serum creatinine and UM (P<0.0001). On admission, CK is a better predictor of ARF due to rhabdomyolysis than creatinine and UM. Initial creatinine is a better predictor of ARF due to rhabdomyolysis than UM. UM assay is not a good investigation for early prediction of ARF in rhabdomyolysis.

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Section: Introductionmentioning

confidence: 99%

Utility of Serum Creatinine, Creatine Kinase and Urinary Myoglobin in Detecting Acute Renal Failure due to Rhabdomyolysis in Trauma and Electrical Burns Patients

Bhavsar

Rathod

et al. 2012

Indian J Surg

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“…The literature describes, using rat and cell culture models [22][23][24][25][26][27] , the deleterious role of this protein, specifically the heme prosthetic group, in the tubular endothelium. This role is associated with the production of reactive oxygen species (ROS) and free radicals in the mitochondria, which initiate lipid peroxidation reactions.…”

Section: Discussionmentioning

confidence: 99%

Kinin B₂receptor does not exert renoprotective effects on mice with glycerol-induced rhabdomyolysis

Gattai¹

2014

WJN

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AIM:To investigate a potential protective role of the kinin B2 receptor in a glycerol-induced rhabdomyolysis mouse model. METHODS:We separated 28 C57Bl/6 male mice into 4 groups: untreated WT animals, untreated B2 knockout mice, glycerol-treated WT and glycerol-treated B2 knockout mice. Glycerol-treated animals received one intramuscular injections of glycerol solution (50% v/v, 7 mL/kg). After 48 h, urine and blood samples were collected to measure creatinine and urea levels. Additionally, kidney samples were extracted for histological evaluation, and the mRNA expression levels of kinin B1 and B2 receptors and inflammatory mediators were measured by real-time polymerase chain reaction. RESULTS:Serum creatinine and urea levels showed differences between untreated wild-type and glyceroltreated wild-type mice (0.66 ± 0.04 vs 2.61 ± 0.53 mg/dL, P < 0.01; and 33.51 ± 2.08 vs 330.2 ± 77.7 mg/dL, P < 0.005), and between untreated B2 knockout mice and glycerol-treated knockout mice (0.56 ± 0.03 vs 2.23 ± 0.87 mg/dL, P < 0.05; and 42.49 ± 3.2 vs 327.2 ± 58.4 mg/dL, P < 0.01), but there was no difference between the glycerol-treated wild-type and glycerol-treated knockout mice. Glycerol was able to induce a striking increase in kinin B2 receptor expression (> 30 times, 31.34 ± 8.9) in kidney. Animals injected with glycerol had a higher degree of tubular injury than untreated animals. Wild-type and knockout mice treated with glycerol intramuscularly present kidney injury, with impairment in renal function. However, B2 knockout mice treated with glycerol did not show a different phenotype regarding kidney injury markers, when compared to the wild-type glycerol-treated group. Gattai PP, Mafra FFP, Wasinski F, Almeida SS, Cenedeze MA, Malheiros DMAC, Bacurau RFP, Barros CC, Câmara NOS, Araujo RC. Kinin B2 receptor does not exert renoprotective effects on mice with glycerol-induced rhabdomyolysis. CONCLUSION: We conclude that the kinin B2 receptor

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“…In a prospective study of 13 patients with rhabdomyolysis, Lappalainen [108] found that the average times to reach the 50% level of initial values were 12 hours for myoglobin and 42 hours for CK ( P < 0.01). In a review of laboratory investigations, Beetham [109] concluded that serum CK levels should be used to screen patients with suspected rhabdomyolysis and that there is no reason for laboratories to have assays for myoglobin available until further studies are able to demonstrate its utility. …”

Section: Assessing Risk Of Renal Failurementioning

confidence: 99%

Crush injury and rhabdomyolysis

Malinoski

Slater

Mullins

2004

Critical Care Clinics

214

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Although clinical syndromes consistent with rhabdomyolysis were recognized in the late 19th and early 20th centuries, the modern history of the crush syndrome begins with Bywaters' and Beal's classic description of the entrapped bombing victims of London during World War II [1 -4]. They reported five cases of crush injury, in which victims had one or more of their extremities trapped under debris for prolonged periods of time. All five patients presented in shock, had swollen extremities, developed dark urine, progressed to renal failure, and eventually died. Histologic examination of the kidney revealed tubular necrosis and pigmented casts. In 1944, Bywaters and Stead identified myoglobin as the urinary pigment and proposed its role in the development of renal failure [5].Large numbers of patients with crush injuries and rhabdomyolysis have been reported after the collapse of mines [6,7], severe beatings [8], and earthquakes [9 -15]. In the United States, alcohol intoxication associated with prolonged muscle compression and seizures is the most common etiology of rhabdomyolysis [16]. Serum creatine kinase (CK) levels correlate with the degree of muscle injury [14] and can be used to assess the severity of rhabdomyolysis. Acute renal failure (ARF) is one of the most serious consequences of rhabdomyolysis and occurs in 4% to 33% of cases, carrying with it a mortality rate of 3% to 50% [17]. Rhabdomyolysis accounts for 5% to 7% of all cases of ARF in the United States [18].This article focuses on the pathophysiology and treatment of myoglobinuric renal failure caused by traumatic rhabdomyolysis and crush injuries.

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Biochemical investigation of suspected rhabdomyolysis

Abstract: This article was prepared at the invitation of the Clinical Laboratory Investigations Standing Committee of the Association of Clinical Biochemists.

Cited by 92 publications

References 40 publications

Utility of Serum Creatinine, Creatine Kinase and Urinary Myoglobin in Detecting Acute Renal Failure due to Rhabdomyolysis in Trauma and Electrical Burns Patients

Utility of Serum Creatinine, Creatine Kinase and Urinary Myoglobin in Detecting Acute Renal Failure due to Rhabdomyolysis in Trauma and Electrical Burns Patients

Kinin B₂receptor does not exert renoprotective effects on mice with glycerol-induced rhabdomyolysis

Crush injury and rhabdomyolysis

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Biochemical investigation of suspected rhabdomyolysis

Abstract: This article was prepared at the invitation of the Clinical Laboratory Investigations Standing Committee of the Association of Clinical Biochemists.

Cited by 92 publications

References 40 publications

Utility of Serum Creatinine, Creatine Kinase and Urinary Myoglobin in Detecting Acute Renal Failure due to Rhabdomyolysis in Trauma and Electrical Burns Patients

Utility of Serum Creatinine, Creatine Kinase and Urinary Myoglobin in Detecting Acute Renal Failure due to Rhabdomyolysis in Trauma and Electrical Burns Patients

Kinin B2receptor does not exert renoprotective effects on mice with glycerol-induced rhabdomyolysis

Crush injury and rhabdomyolysis

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Kinin B₂receptor does not exert renoprotective effects on mice with glycerol-induced rhabdomyolysis