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      Rabdomiolisis inducida por el ejercicio Translated title: Exercise-induced rhabdomyolysis

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          Abstract

          La rabdomiolisis constituye un síndrome clínico y bioquímico resultado del daño muscular, necrosis del músculo esquelético y liberación del contenido celular al torrente circulatorio. Existe una gran heterogeneidad en la forma de presentación clínica, los pacientes suelen referir dolores musculares, debilidad y malestar general, pero las complicaciones pueden ser severas: arritmias cardiacas y fracaso renal agudo. Se han descrito numerosas causas (enfermedades hereditarias del metabolismo, traumatismos, ejercicio, fármacos, inmovilización, trastornos metabólicos, enfermedades infecciosas, etc.). Presentamos el caso de un varón de 38 años, bombero de profesión y gran deportista, que refería una historia de dolor muscular, calambres y debilidad de dos días de evolución, tras la práctica de ejercicio.

          Translated abstract

          Rhabdomyolisis is defined as a clinical and biochemical syndrome resulting from skeletal muscle injury that alters the integrity of the muscle cell membrane sufficiently to allow the release of the muscle cell contents into the plasma. There is a great heterogeneity in the clinical presentation of rhabdomyolysis. Patiens often have swollen and painful muscles. Cardiac arrest, and acute renal failure are the major complications. Numerous precipitating factors of rhabdomyolysis have been described (hereditary enzyme defects, exercise, drugs, trauma, immobilization, metabolic acidosis, infectious diseases,...). We present the case of a 38 year old male, fireman and sportman, who had a two days history of myalgias, tenderness and weakness after extreme exercise.

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          Factors predictive of acute renal failure in rhabdomyolysis.

          In a historical cohort study, acute renal failure developed in 16.5% of 157 patients with rhabdomyolysis over a two-year study period. Underlying clinical, laboratory, and causative factors associated with the development of acute renal failure were examined. Factors predictive of renal failure in this setting, determined by multiple logistic regression analysis, included the degree of serum creatine kinase, serum potassium, and serum phosphorus level elevation; the degree of depression of serum albumin level; and the presence of dehydration at presentation or sepsis as the underlying cause. The predictive model that was developed correctly classified 93% of subjects and was statistically validated.
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            Exercise-induced rhabdomyolysis.

            To describe the syndrome of exercise-induced rhabdomyolysis and to investigate the relation between exercise-induced rhabdomyolysis and the development of acute renal failure. Retrospective chart analysis on all patients with a discharge diagnosis of rhabdomyolysis from January 1988 to January 1993. An urban tertiary care center with 225,000 annual emergency department visits. Thirty-five patients met the inclusion criteria for exercise-induced rhabdomyolysis: a history of strenuous exercise, creatine phosphokinase level more than 500, and urine dipstick positive for blood without hematuria. We excluded patients with a history of trauma, myocardial infarction, stroke, or documented sepsis. Charts also were examined for the presence of nephrotoxic cofactors (ie, hypovolemia and/or acidosis). All 35 patients were men without significant past medical history and were an average age of 24.4 years. The average admission creatine phosphokinase was 40,471 U/L. No patient presented with or developed nephrotoxic cofactors during hospitalization. None of our study patients experienced acute renal failure. Previous literature has described a 17% to 40% incidence of acute renal failure in rhabdomyolysis. None of our patients developed acute renal failure, signifying a much lower incidence of acute renal failure in exercise-induced rhabdomyolysis without nephrotoxic cofactors than in other forms of rhabdomyolysis.
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              Exercise-induced rhabdomyolysis.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                medif
                Medifam
                Medifam
                Arán Ediciones, S. L. (, , Spain )
                1131-5768
                November 2001
                : 11
                : 9
                : 92-95
                Affiliations
                [03] Madrid orgnameHospital La Paz
                [01] Madrid orgnameCentro de Salud Ciudad de los Periodistas
                [02] Madrid orgnameCentro de Salud Ciudad de los Periodistas
                Article
                S1131-57682001000900008
                10.4321/s1131-57682001000900008
                dd68f0e0-d841-49a3-a3f2-03c4c3628e46

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 13, Pages: 4
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                SciELO Spain


                Rabdomiolisis,Ejercicio,Creatina kinasa,Rhabdomyolysis,Exercise,Creatine- kinase

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