Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients

Li, Xiayin; Bai, Ming; Yu, Yan; Ma, Feng; Zhao, Lijuan; Li, Yajuan; Wu, Hao; Zhou, Lei; Sun, Shiren

doi:10.1080/0886022x.2022.2132170

Cited by 4 publications

(3 citation statements)

References 61 publications

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“…CRRT is more effective than conventional dialysis in clearing medium and large molecules from the bloodstream. [22] Secondly, CRRT allows for dynamic adjustment of electrolyte and pH concentrations in the replacement solution based on real-time blood gas analysis results, providing superior control compared to conventional dialysis. [23] Following CRRT treatment, the patient experienced alleviation of clinical symptoms and decreased serum levels of CK and myoglobin.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report

Lu,

Li,

You

et al. 2023

Medicine

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Rationale: Rhabdomyolysis can be an uncommon complication of coronavirus disease 2019 (COVID-19) infection. However, the diagnosis of rhabdomyolysis could be easily missed due to its atypical clinical presentations. We present a patient with a history of end-stage renal disease (ESRD) who contracted COVID-19 and subsequently developed rhabdomyolysis. We discuss and share our experience in the management of this patient. Patient concerns: An 85-year-old male with ESRD undergoing routine hemodialysis was tested positive for COVID-19. The patient had clinical symptoms of fatigue, muscle pain, and difficulty walking. Diagnosis: The serum creatine kinase (CK) level was markedly elevated to 32,492.9U/L, supporting the diagnosis of rhabdomyolysis. A computed tomography scan revealed muscle injuries throughout the body, confirming the diagnosis. Interventions: The patient was managed through electrolyte corrections and continuous renal replacement therapy. Outcomes: Repeat tests showed decreased levels of serum CK and negative severe acute respiratory syndrome coronavirus 2. His clinical symptoms, including fatigue and muscle pain, had significantly improved. Lessons: COVID-19 infection can cause muscle pain and fatigue, which can mask the symptoms of rhabdomyolysis. A missed diagnosis of rhabdomyolysis can be severe, especially in patients with ESRD. The serum CK level should be tested with clinical suspicion. Appropriate management, including adequate hydration and electrolyte balance, should be provided. Continuous renal replacement therapy should be considered in affected patients with renal insufficiency.

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Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report

Lu,

Li,

You

et al. 2023

Medicine

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“…There is no strong clinical evidence regarding the use of mannitol and bicarbonates, although their use can lead to renal vasodilatation and clearance of free radicals, with potential for renal function preservation, their use in patients with rhabdomyolysis is still controversial 1 . Early CRRT is associated with a reduction of mortality, as it preserves renal function, thanks to the removal of myoglobin and CPK, and reduction of their deposition on renal tubules 7 . The addition of adsorbent filters to the circuit contributes to effectively reduce myoglobin and CPK levels and to improve patient outcome 8,9 .…”

Section: Discussionmentioning

confidence: 99%

“…1 Early CRRT is associated with a reduction of mortality, as it preserves renal function, thanks to the removal of myoglobin and CPK, and reduction of their deposition on renal tubules. 7 The addition of adsorbent filters to the circuit contributes to effectively reduce myoglobin and CPK levels and to improve patient outcome. 8,9 CytoSorb® is a sorbent filter characterized by a biocompatible polymer with high porosity and a surface capable of absorbing hydrophobic substances with medium-low molecular weight, it is indicated to remove cytokines, bilirubin, and myoglobin.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis as cause, consequence, or mimicker of myocardial infarction: A case report

Nasello,

Ippolito,

Federico

et al. 2023

Clinical Case Reports

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Key Clinical MessageA timely diagnosis is essential to start appropriate therapy and to reduce risks of life‐threatening complications of rhabdomyolysis. Some cases can undergo differential diagnosis with other clinical conditions, e.g., myocardial infarction.AbstractWe present the case of a 65‐years‐old male who was admitted to the emergency department with a clinical presentation related to myocardial infarction. The patient underwent coronary angioplasty and was then admitted to ICU due to hemodynamical instability, elevated potassium levels, and anuria. Further investigations revealed rhabdomyolysis. The patient received vasopressors, oxygenation support and renal replacement therapy. Outcomes at ICU discharge were favorable. The temporal association between rhabdomyolysis and myocardial infarction, together with an unclear pathophysiological relationship, made differential diagnosis difficult. We discuss this uncertainty in light of published literature.

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Extracorporeal pediatric renal replacement therapy: diversifying application beyond kidney failure

Chanchlani,

Askenazi,

Bayrakci

et al. 2024

Pediatr Nephrol

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The utilization of extracorporeal renal replacement therapy (RRT), including continuous renal replacement therapy (CRRT) and hemodialysis (HD), beyond the treatment of volume overload and acute kidney injury (AKI) has witnessed a significant shift, demonstrating the potential to improve patient outcomes for a range of diseases. This comprehensive review explores the non-kidney applications for RRT platforms in critically ill children, focusing on diverse clinical scenarios such as sepsis, inborn errors of metabolism, liver failure, drug overdose, tumor lysis syndrome, and rhabdomyolysis. In the context of sepsis and septic shock, RRT not only facilitates fluid, electrolyte, and acid/base homeostasis, but may offer benefits in cytokine regulation, endotoxin clearance, and immunomodulation which may improve multi-organ dysfunction as well as hemodynamic challenges posed by this life-threatening condition. RRT modalities also have an important role in caring for children with inborn errors of metabolism, liver failure, and tumor lysis syndrome as they can control metabolic derangements with the efficient clearance of endogenous toxins in affected children. In cases of drug overdose, RRT is a crucial tool for rapid extracorporeal clearance of exogenous toxins, mitigating potential organ damage. The intricate interplay between liver failure and kidney function is examined, elucidating the role of RRT and plasma exchange in maintaining fluid and electrolyte balance when hepatic dysfunction complicates the clinical picture. Furthermore, RRT and HD are explored in the context of rhabdomyolysis, highlighting their utility in addressing AKI secondary to traumatic events and crush syndrome. Graphical abstract

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Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients

Cited by 4 publications

References 61 publications

Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report

Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report

Rhabdomyolysis as cause, consequence, or mimicker of myocardial infarction: A case report

Extracorporeal pediatric renal replacement therapy: diversifying application beyond kidney failure

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