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[Myoglobinuria and acute renal failure].

A Hishida1, A Kato, M Yamada

  • 11st Department of Medicine, Hamamatsu University School of Medicine.

Rinsho Byori. the Japanese Journal of Clinical Pathology
|February 1, 1991
PubMed
Summary

Acute renal failure (ARF) occurs in 30% of rhabdomyolysis cases. Dehydration, hypotension, sepsis, and burns are risk factors for ARF development in rhabdomyolysis.

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Area of Science:

  • Nephrology
  • Pathophysiology
  • Toxicology

Context:

  • Acute renal failure (ARF) is a significant complication of rhabdomyolysis.
  • Rhabdomyolysis-associated ARF constitutes 5-10% of all ARF cases.
  • Understanding the risk factors and pathogenesis is crucial for clinical management.

Purpose:

  • To review clinical and experimental studies on myoglobinuria-associated ARF.
  • To identify risk factors contributing to ARF in rhabdomyolysis.
  • To investigate the pathogenesis of ARF in glycerol-induced models.

Summary:

  • ARF developed in 30% of rhabdomyolysis cases, with dehydration, hypotension, sepsis, or burns increasing risk.
  • Glycerol-induced ARF models in animals revealed early decreases in inulin clearance linked to reduced renal blood flow.
  • Late-phase decreases in inulin clearance in glycerol-induced ARF were associated with diminished glomerular permeability and cast formation, not solely renal blood flow reduction.

Impact:

  • Highlights dehydration and hypotension as key risk factors for rhabdomyolysis-associated ARF.
  • Provides insights into the early and late-phase mechanisms of ARF in rhabdomyolysis.
  • Informs potential therapeutic strategies by elucidating the pathophysiology of myoglobinuria-induced kidney injury.

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