İSKENDER KARA, Hamit KÜÇÜK, Lale KARABIYIK, İsmail KATI

MULTİTRAVMA SONRASI RABDOMİYOLİZ GELİŞEN OLGUDA AKUT BÖBREK YETMEZLİĞİ

Etiyolojisinde pekçok faktör bulunan rabdomiyoliz, sıklıkla travmaya bağlı olarak gelişir ve özellikle majör travmalar sonrasında yüksek oranlarda görülebilir. Rabdomiyoliz gelişen hastaların bir kısmında akut böbrek yetmezliği gelişebilir. Travmanın sık karşılaşılan sebeplerinden olan trafik kazalarında hastalar genellikle multipl doku ve organ hasarlarına sahiptirler. Bu olgularda daha çok kraniyal, torakal ve abdominal alanlardaki patolojilere odaklanıldığı için, gözlenebilir kas hasarı olmayan hastalarda gelişebilen rabdomiyoliz gözden kaçabilmektedir. Bu olguda, trafik kazası sonrası multitravmada rabdomiyolize bağlı gelişen ve erken fark edilen akut böbrek yetmezliğinin tekrarlı diyaliz uygulamalarıyla başarılı tedavisi sunulmuştur.

ACUTE RENAL FAILURE IN A MULTIPLE TRAUMA PATIENT WITH RHABDOMYOLYSIS

Rhabdomyolysis, the etiology of which has many factors, often occurs due to trauma, and especially following major trauma seen in high rates. In a subset of patients with rhabdomyolysis acute renal failure may occur. Patients in traffic accidents, one of the most common causes of trauma, often have multiple tissue and organ damage. In such cases, since the focus is more on pathologies in cranial, thoracic, and abdominal areas, rhabdomyolysis may be overlooked in patients with no observable muscle damage. In this case, successful treatment with repeated dialysis treatment of acute renal failure due to rhabdomyolysis following multiple trauma in a traffic accident, perceived in the early stages, is presented.

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Melli G, Chaundry V, Cornblath DR. Rhabdomyolysis; an evaluation of 475 hospitalized patients. Medicine 2005; 84: 377-385.
Counselman FL, Lo BM. Rhabdomyolysis. Tintinalli JE, Stapczynski JS, Ma OJ, Cline DM, Cydulka RK, Meckler GD. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, Seventh Edition. Nobel T›p Kitabevleri: McGraw-Hill; 2013; 622-624.
Khan FY. Rhabdomyolysis: a review of the literatüre. Neth J Med 2009; 67: 272-283.
Shapiro ML, Baldea A, Luchette FA. Rhabdomyolysis in the intensive care unit. J Intensive Care Med 2012; 27: 335-342.
Bagley WH, Yang H, Shah KH. Rhabdomyolysis. Intern Emerg Med 2007; 2: 210-218.
Bywaters EGL, Beall D. Crush injuries with impairment of renal function. 1941. J Am Soc Nephrol 1998; 9: 322-332.
Chatzizisis YS, Misirli G, Hatzitolios AI, Giannoglou GD. The syndrome of rhabdomyolysis: complications and treatment. Eur J Intern Med 2008; 19: 568-574.
Veenstra J, Smit WM, Krediet RT, Arisz L. Relationship between elevated creatine phosphokinase and the clinical spectrum of rhabdomyolysis. Nephrol Dial Transplant 1994; 9: 637-641.
Onur Ö, Güneysel Ö, Eroğlu S, Denizbaşı A, Ünlüer E. Rabdomiyolize Bağlı Gelişen Akut Tubuler Nekrozda Kas Kitlesinin Önemi: Olgu Sunumu. Marmara Medical Journal 2006; 19; 30-32.
Bonventre J, Shah S, Walker R, Humphreys M. Rhabdomyolysisinduced acute renal failure. In: Jacobson H, Striker G, Klahr S (Eds.), The principles and practice of nephrology (2nd ed.) St. Louis: Mosby-Year Book, Inc. 1995: 569-573.
Kasaoka S, Todani M, Kaneko T, Kawamura Y, Oda Y, Tsuruta R, Maekawa T. Peak value of blood myoglobin predicts acute renal failure induced by rhabdomyolysis. J Crit Care 2010; 25: 601-604.
Fernandez WG, Hung O, Bruno R. Factors predictive of acute renal failure and need for hemodialysis among ED patients with rhabdomyolysis. Am J Emerg Med 2005; 23: 1-7.
Odeh M. The role of reperfusion-induced injury in the pathogenesis of the crush syndrome. N Engl J Med 1991; 324:1417-1422.
Zager RA. Rhabdomyolysis and myohemoglobinuric acute renal failure. Kidney Int 1996; 49: 314-326.
Better OS, Stein JH. Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Engl J Med 1990; 322: 825-829.
R Yılmaz, S Apaydın, N Gazioğlu. Torakal Omurga Cerrahisi Sonrası Gelişen Rabdomiyoliz: İki Pediatrik Olgu ve Literatürün Gözden Geçirilmesi. Dirim Tıp Gazetesi 2009; 84: 59-63.