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[Acute kidney failure in hypothermia]

H Kopsa, J Zazgornik, P Schmidt

    Schweizerische Medizinische Wochenschrift
    |July 9, 1977
    PubMed
    Summary
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    Prolonged hypothermia can cause acute renal failure and severe muscle damage, even without visible trauma. Prompt hemodialysis and supportive care can restore normal kidney and muscle function.

    Area of Science:

    • Nephrology
    • Toxicology
    • Emergency Medicine

    Background:

    • Acute renal failure (ARF) is a critical condition requiring prompt diagnosis and management.
    • Hypothermia, particularly prolonged exposure, presents unique challenges in critical care medicine.

    Observation:

    • Two cases of ARF following prolonged hypothermia are presented.
    • Patients exhibited rapid uremia, severe metabolic acidosis, and elevated muscle enzymes, indicative of rhabdomyolysis.
    • No visible crush injuries were observed, despite laboratory evidence of significant muscle damage.

    Findings:

    • Nontraumatic rhabdomyolysis, induced by hypothermia, was identified as a key factor.
    • Hypotension and reduced renal perfusion contributed to the development of ARF.
    • Hemodialysis was crucial in managing uremia and metabolic disturbances.

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    Implications:

    • This study highlights the risk of ARF and rhabdomyolysis in hypothermia patients, even without physical trauma.
    • Early recognition of hypothermia-induced muscle damage and renal impairment is vital.
    • Effective management involves addressing hypotension, supporting renal function, and utilizing hemodialysis.