Severe mixed metabolic acidosis secondary to rhabdomyolysis

A patient with severe metabolic acidosis in association with rhabdomyolysis and nonoliguric acute renal failure is presented. Evaluation of his acidosis indicated a large excess of unmeasured anions as well as evidence of a renal acidifying defect. We conclude that the metabolic acidosis seen with myoglobinuric acute renal failure may represent a mixed acid-base disturbance.