Document Type : Case Report
Authors
1 Department of Nephrology, Faculty of Medicine, Mugla Sıtkı Koçman University, Mugla, Turkey
2 Department of Internal Medicine, Faculty of Medicine, Mugla Sıtkı Koçman University, Mugla, Turkey
Abstract
Objective: Rhabdomyolysis is an important etiology for developing acute kidney injury
(AKI). Among the many varying reasons for rhabdomyolysis, electrical injury seems to be
a lesser-known factor. The clinical presentation of rhabdomyolysis is usually in the form
of severe and widespread pain, tenderness, weakness in the muscles and dark urine. It
is characterized by the disruption of cell integrity in myocytes as a result of widespread
damage to skeletal muscles and the passage of intracellular components into the
circulation.
Case Presentation: Here we presented a case report of a young man who had
rhabdomyolysis induced by electrical injury which is relatively less common among the
other etiological factors with preserved renal functions. He had electrical injury related
wounds on extremities. Urgent intravenous fluid therapy was initiated as soon as his
admission to the emergency department (ED), without delay.
Conclusion: AKI is very common due to the nephrotoxic effect of myoglobinuria and the
prerenal status. It is rare that AKI does not develop in patients with a severe increase in
creatinine kinase. It is a very important point to start effective fluid therapy in a short time.
Keywords
Main Subjects
2022;3(11):1969-79. doi: 10.34067/kid.0005442022.
2. Gille J, Schmidt T, Dragu A, Emich D, Hilbert-Carius P, Kremer T, et al. Electrical injury - a dual center analysis of patient characteristics, therapeutic specifics and outcome predictors.Scand J Trauma Resusc Emerg Med. 2018;26(1):43. doi:10.1186/s13049-018-0513-2.
3. Boyd AN, Hartman BC, Sood R, Walroth TA. A voltage-based analysis of fluid delivery and outcomes in burn patients with electrical injuries over a 6-year period. Burns. 2019;45(4):869-75. doi: 10.1016/j.burns.2018.08.020.
4. Bywaters EG, Beall D. Crush injuries with impairment of renal function. Br Med J. 1941;1(4185):427-32. doi: 10.1136/
bmj.1.4185.427.
5. Chavez LO, Leon M, Einav S, Varon J. Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical
practice. Crit Care. 2016;20(1):135. doi: 10.1186/s13054-016-1314-5.
6. Culnan DM, Farner K, Bitz GH, Capek KD, Tu Y, Jimenez C, et al. Volume resuscitation in patients with high-voltage
electrical injuries. Ann Plast Surg. 2018;80(3 Suppl 2):S113-S8. doi: 10.1097/sap.0000000000001374.
7. Yang J, Zhou J, Wang X, Wang S, Tang Y, Yang L. Risk factors for severe acute kidney injury among patients with
rhabdomyolysis. BMC Nephrol. 2020;21(1):498. doi:10.1186/s12882-020-02104-0.
8. de Meijer AR, Fikkers BG, de Keijzer MH, van Engelen BG,Drenth JP. Serum creatine kinase as predictor of clinical course in rhabdomyolysis: a 5-year intensive care survey. Intensive Care Med. 2003;29(7):1121-5. doi: 10.1007/s00134-003-1800-5.
9. Stewart IJ, Cotant CL, Tilley MA, Huzar TF, Aden JK, Snow BD, et al. Association of rhabdomyolysis with renal outcomes and mortality in burn patients. J Burn Care Res. 2013;34(3):318-25. doi: 10.1097/BCR.0b013e31825addbd.
10. Kamal F, Snook L, Saikumar JH. Rhabdomyolysis-associated acute kidney injury with normal creatine phosphokinase. Am J Med Sci. 2018;355(1):84-7. doi: 10.1016/j.amjms.2017.04.014.
11. Hansrivijit P, Yarlagadda K, Puthenpura MM, Cunningham JM. Extremely high creatine kinase activity in rhabdomyolysis without acute kidney injury. Am J Case Rep. 2020;21:e924347.doi: 10.12659/ajcr.924347.
12. Navarrete N. Hyperkalemia in electrical burns: a retrospective study in Colombia. Burns. 2018;44(4):941-6. doi: 10.1016/j.burns.2017.12.003