Rhabdomyolysis Flashcards
What is rhabdomyolysis?
Release of myoglobin from damaged muscles which can block kidneys causing intrinsic AKI
What are some causes of rhabdomyolysis?
Trauma
Crush injury
Compartment syndrome
Marathon running
Hypothermia and shivering
Hot weather
Muscle wasting
ALcohol, opiates, infections
Why does rhabdomyolysis cause AKI?
Myoglobin obstructs thekidneys and the PCT damaged by haem
What would the urine look like in someone with rhabdomyolysis?
Red/tea coloured - myoglobin casts
These are pigmented
What would happen to CK in rhabdomyolysis?
Raised - muscle damage
What would happen to LDH in rhabdomyolysis?
Increase
What would happen to K+ in rhabdomyolysis?
Increase due to kidney damage and from necrosed muscle
What would happen to phosphate in rhabdomyolysis?
Increase - ATP from muscle
What would happen to uric acid in rhabdomyolysis?
Increase - from muscle cell DNA
What would happen to calcium in rhabdomyolysis?
Reduced - it binds to damaged muscle
What would happen to circulating blood in rhabdomyolysis?
Reduces - accumulates in damaged kidneys
What would happen to calcium in rhabdomyolysis treatment?
Increases - reduced by muscles
How do you prevent rhabdomyolysis from leading to AKI?
Improve renal perfusion - IV fluid
NB - if already damaged be awayre of pulmonary oedema
Mannitol - forced diuresis and increase urine output to empty out myoglobin
alkaline diuresis - haem is acidic and this counteracts it, and free radical damage from myoglobin
What is a complication of alkalanisation?
Worsening hypocalcaemia - causes calcium to bind to albumin
what is a complication of mannitol?
Hypernaetremia and pulmonary oedema
