Rhabdomyolysis-Induced Acute Kidney Injury Treated with Medium Cut-Off Membrane: A Case Report

Area of Science:

• Nephrology
• Toxicology
• Intensive Care Medicine

Background:

• Acute kidney injury (AKI) is a common complication of rhabdomyolysis, occurring in 10-40% of patients.
• Diagnosis relies on myoglobinuria and elevated creatine kinase (CK).
• Intermittent hemodialysis is a treatment option for rhabdomyolysis with azotemia or oliguria.

Observation:

• A 31-year-old male presented with severe lower limb pain, hypertension, elevated creatinine (15.7 mg/dL), and extremely high CK levels (>20,000 IU/L) after extensive exercise.
• Initial intermittent hemodialysis was insufficient, and the patient developed posterior reversible encephalopathy syndrome and seizures.
• A further increase in CK levels was noted despite conventional treatment.

Findings:

• Extracorporeal removal of myoglobin using a medium cut-off (MCO) membrane was initiated.
• Three sessions with the MCO membrane led to significant reductions in myoglobin and CK levels.
• The patient was successfully transitioned to conventional dialysis and discharged with complete renal recovery.

Implications:

• Medium cut-off membrane technology offers an effective method for myoglobin clearance in severe rhabdomyolysis-induced AKI.
• This approach achieves significant reduction in myoglobin and CK without substantial albumin loss.
• MCO membrane dialysis presents a potentially cost-effective and efficient therapeutic option for managing this critical condition.