Rhabdomyolisys as a Cause of Acute Renal Injury

M. Nikolova 1 , N. Guerguinova 1 , T. Tsocheva 1 , D. Vasilieou 1 , M. Hristova 1 , N. Hubanov 1 , V. Papazov 1 , Al. Kirilov 1 , V. Mushekov 1 , E. Manov 1 , Y. Vlahov 1 , V. Bogdanova 1 , K. Petkov 1 , K. Davidov 1 , D. Yosifov 1 , D. Ivanova 1 , R. Krasteva 1 ,  and B. Bogov 1
  • 1 Medical University – Sofia, , Bulgaria


Rhabdomyolysis (RM) is defined as striate muscle-cell damage with disintegration of skeletal muscles and release of intracellular constituents to the circulation, with or without subsequent kidney injury. RM is one of the leading causes of acute kidney injury and is associated with substantial morbidity. The major signs of acute kidney injury in rhabdomyolysis are: pain, weakness and swelling of the injured muscle or muscle groups and myoglobinuria with reddish discoloration of the urine and decrease in urine output to anuria. The authors describe three cases of rhabdomyolysis with acute renal injury and discuss the current knowledge on the etiopathogenesis, clinical manifestations, diagnosis and treatment of this condition.

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  • 1. Vanholder R, Sever MS, Erek E, Lameire N. Rhabdomyolysis. J Am Soc Nephrol 2000;11:1553-1561.

  • 2. Petejova N, Martinek A. Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. Critical Care 2014;18:224-231.

  • 3. Panizo N, Rubio-Navarro A, Amaro-Villalobo JM, et al. Molecular mechanisms and novel therapeutic approaches to rhabdomyolysis-induced acute kidney injury. Kidney Blood Press Res 2015;40:520-532.

  • 4. Williams J, Thorpe C. Rhabdomyolysis. Continuing Education in Anaesthesia, Critical Care &Pain J 2014;4:163-166.

  • 5. Zimmerman JL, Shen MC. Rhabdomyolysis. Chest 2013;144:1058-1065.

  • 6. Rutecki GW, Ognibene AJ, Geib JD. Rhabdomyolysis in antiquity: From ancient descriptions to scientific explanation. Pharos 1998;61:18-22.

  • 7. Rizzi D, Basile C, Di Maggio A, et al. Clinical spectrum of accidental hemlock poisoning: Neurotoxic manifestations, rhabdomyolysis and acute tubular necrosis. Nephrol Dial Transplant 1991;6: 939-943.

  • 8. Bywaters EGL, Beall D. Crush injuries with impairment of renal function. Br Med J 1941;1:427-432.

  • 9. Bywaters EGL, Popjak G. Experimental crushing injury: Peripheral vascular collapse and other effects of muscle necrosis in the rabbit. Surg Gynecol Obstet 1942;75:612-627.

  • 10. Koffler A, Friedler RM, Massry SG. Acute renal failure due to nontraumatic rhabdomyolysis. Ann Intern Med 1976;85:23-28.

  • 11. Grossman RA, Hamilton RW, Morse BM, et al. Nontraumatic rhabdomyolysis and acute renal failure. N Engl J Med 1974, 291: 807-81.

  • 12. Naik BS, Chakpani M. A rare case of brucine poisoning complicated by rhabdomyolysis and acute renal failure. Malays J Pathol 2009;31(1):67-69.

  • 13. Ben Ghezala H, Chaouali N, Gana I, et al. Toxic effects of Rhamnus alaternus: a rare case report. Case Reports in Emergency Medicine 2015; Article ID 182951:5 pages.

  • 14. Disel R, Yilmaz M,Kekec Z, Karanlik M. Poisoned after dinner: dolma with Datura Stramonium. Turk J Emerg Med 2015;15(1):51-55.

  • 15. Ho LM, Cheong I, Jalil HA. Rhabdomyolysis and acute renal failure following blowpipe dart Poisoning. Nephron 1996;72:676-678.

  • 16. Spiegel LR, Schrier PB, Shah HH. Severe recurrent rhabdomyolysis-induced acute kidney injury in a HIV-infected patient on antiretroviral therapy. Ren Fail 2013;35(8):1186-1190.

  • 17. Holt SG, Moore KP. Pathogenesis and treatment of renal dysfunction in rhabdomyolysis. Intensive Care Med 2001;27:803-811.

  • 18. Nance JR, Mammen AL. Diagnostic evaluation of rhabdomyolysis. Muscle Nerve 2015;51(6):793-810.


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