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      Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review

      review-article
      1 , , 1
      Critical Care
      BioMed Central

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          Abstract

          Rhabdomyolysis, a clinical syndrome caused by damage to skeletal muscle and release of its breakdown products into the circulation, can be followed by acute kidney injury (AKI) as a severe complication. The belief that the AKI is triggered by myoglobin as the toxin responsible appears to be oversimplified. Better knowledge of the pathophysiology of rhabdomyolysis and following AKI could widen treatment options, leading to preservation of the kidney: the decision to initiate renal replacement therapy in clinical practice should not be made on the basis of the myoglobin or creatine phosphokinase serum concentrations.

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          Most cited references44

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          Resuscitation Fluids

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            Rhabdomyolysis: a review of the literature.

            F Y Khan (2009)
            Rhabdomyolysis is a potentially life-threatening syndrome that can develop from a variety of causes; the classic findings of muscular aches, weakness and tea-coloured urine are non-specific and may not always be present. The diagnosis therefore rests upon the presence of a high level of suspicion of any abnormal laboratory values in the mind of the treating physician. An elevated plasma creatine kinase (CK) level is the most sensitive laboratory finding pertaining to muscle injury; whereas hyperkalaemia, acute renal failure and compartment syndrome represent the major life-threatening complications. The management of the condition includes prompt and aggressive fluid resuscitation, elimination of the causative agents and treatment and prevention of any complications that may ensue. The objective of this review is to describe the aetiological spectrum and pathophysiology of rhabdomyolysis, the clinical and biological consequences of this syndrome and to provide an appraisal of the current data available in order to facilitate the prevention, early diagnosis and prompt management of this condition.
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              Rhabdomyolysis.

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                Author and article information

                Contributors
                Journal
                Crit Care
                Crit Care
                Critical Care
                BioMed Central
                1364-8535
                1466-609X
                2014
                28 May 2014
                28 May 2015
                : 18
                : 3
                : 224
                Affiliations
                [1 ]Department of Internal Medicine, University Hospital Ostrava, 17 listopadu 1790, 708 52 Ostrava, Czech Republic
                Article
                cc13897
                10.1186/cc13897
                4056317
                25043142
                7a2aab83-b2c3-4856-846d-5fc9d12e0b48
                Copyright © 2014 Petejova and Martinek; licensee BioMed Central Ltd.

                The licensee has exclusive rights to distribute this article, in any medium, for 12 months following its publication. After this time, the article is available under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Review

                Emergency medicine & Trauma
                Emergency medicine & Trauma

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