Rhabdomyolysis and acute renal failure after strenuous exercise and alcohol abuse: case report and literature review.
BACKGROUND
Rhabdomyolysis is a severe and life-threatening condition in which skeletal muscle is damaged. Acute renal failure due to rhabdomyolysis has been widely described and its main pathophysiological mechanisms are renal vasoconstriction, intraluminal cast formation and direct myoglobin toxicity.


OBJECTIVE
To report on a case of acute renal failure (ARF) induced by rhabdomyolysis due to strenuous exercise and alcohol abuse and to describe the pathophysiology of this type of ARF.


METHODS
A 39-year-old man arrived at the hospital emergency service with swollen legs and lower extremity compartment syndrome. He was oliguric and had serum creatinine and urea levels of 8.1 mg/dl and 195 mg/dl, respectively. The diagnosis of rhabdomyolysis was made through clinical and laboratory findings (creatine kinase activity of 26320 IU/l). The initial treatment consisted of fluid replacement and forced diuresis. The specific treatment for compartment syndrome, such as fasciotomy, was avoided in order to prevent infection. Partial recovery of renal function was recorded, after ten hemodialysis sessions. Complete recovery was observed after two months of follow-up.
Daher
Elizabeth De Francesco
Ede F
Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil. geraldobezerrajr@hotmail.com
Silva Júnior
Geraldo Bezerra da
GB
Brunetta
Denise Menezes
DM
Pontes
Lícia Borges
LB
Bezerra
Glaydcianne Pinheiro
GP
D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000435:Alcoholic Intoxication / Q000150:complications*; D015444:Exercise; D006801:Humans; D008297:Male; D012206:Rhabdomyolysis / Q000150:complications*