rhabdomyolysis and aki

Question 1

Crush syndrome

Answer 1

result if massive muscle breakdown usually caused by crush injury, hyperthermia, drug overdose

releases myoglobin Mb into the circulation which becomes deposited in renal tubules

causes renal failure
acute renal failure

Question 2

F2- Isoprostanes

Answer 2

formed during lipid peroxidation
potent renal vasoconstrictors
levels increased in hepatorenal syndrome

Question 3

myoglobin Mb

Answer 3

increases formation of isoprostanes

induces lipid peroxidation

deposition of Mb in kidney causes oxidative stress and formation of isoprostanes which can cause kidney failure

Question 4

cause of rhabdomyolysis-induced renal failure

Answer 4

redox cycling of Mb between ferric and ferryl oxidation states, which induces an oxidant injury to the kidney

Question 5

rhabdomyolysis

Answer 5

Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents (proteins and electrolytes) into the bloodstream. This can lead to serious complications such as renal (kidney) failure. This means the kidneys cannot remove waste and concentrated urine.

Question 6

rhabdo signs

Answer 6

muscle pain in the shoulders, thighs, or lower back; muscle weakness or trouble moving arms and legs; and dark red or brown urine or decreased urination.

Abdominal pain
Nausea or vomiting
Fever, rapid heart rate
Confusion, dehydration, fever, or lack of consciousness

Question 7

diagnosing rhabdo

Answer 7

Blood tests for creatine kinase, a product of muscle breakdown, and urine tests for myoglobin, a relative of hemoglobin that is released from damaged muscles, can help diagnose rhabdomyolysis (although in half of people with the condition, the myoglobin test may come up negative).

Common complications of rhabdomyolysis include very high levels of potassium in the blood, which can lead to an irregular heartbeat or cardiac arrest and kidney damage (which occurs in up to half of patients). About one in four also develop problems with their liver. A condition called compartment syndrome may also occur after fluid resuscitation. This serious compression of nerves, blood vessels, and muscles can cause tissue damage and problems with blood flow.

Question 8

treating rhabdo

Answer 8

Treatment with intravenous (IV) fluids helps maintain urine production and prevent kidney failure. Rarely, dialysis treatment may be needed to help your kidneys filter waste products while they are recovering. Management of electrolyte abnormalities (potassium, calcium and phosphorus) helps protect your heart and other organs. You may also need a surgical procedure (fasciotomy) to relieve tension or pressure and loss of circulation if compartment syndrome threatens muscle death or nerve damage. In some cases, you may need to be in the intensive care unit (ICU) to allow close monitoring.

Question 9

paracetamol

Answer 9

Experimental data from mouse models of rhabdomyolysis showed that paracetamol reduces the expected increase in serum creatinine level.