Study of Acute Renal Failure in Rhabdomyolysis

A total of twenty four cases of acute renal failure due to rhabdomyolysis were studied in Dhaka Medical College Hospital in last 3 years in terms of clinical presentation and biochemical parameters including prognosis after treatment. Mean age (mean±SD) were 32±10 years ranged from 22 to 72 years, male 22 and female 2 cases. Common presentation were anorexia, nausea vomiting 22 (91.66%), decreased urine output 20 (83.33%), generalized body ache 12 (50%),painful swelling of limbs 6 (25%),fever 3 (15%), convulsion fracture of lower limb 2 (8.33%) each and abdominal pain in one case. Main causes were physical assault 12 (50%), near- drowning 3 (12.5%), vigorous exercise 3 (12.5%), road traffic accident (RTA) 2 (8.3%), convulsion (epilepsy), self induced trauma, septicaemia and post partum eclampsia with convulsion 1 in each case. Mean haemoglobin was 11.66 gm/ dl, total count of WBC 13400/ cu.mm. of blood with neutrophil 77.38%, urinary albumin 1+in 14 cases, 2+ in 10 cases and mean urinary RBC 4/HPF and pus cell (WBC) 6/ HPF. Mean blood urea and serum creatinine were 161 mg/dl and 10 mg/dl respectively. Mean serum potassium (K+) 5.9 mmol/L (K+ 6.0 mmol/L in 12 cases). Mean serum CPK was 2341IU/L, LDH1300IU/L, aldolase 1636IU/L, SGOT199 IU/L, blood sugar 5.8 mmol/L. Among 24, six patients (25%) were treated conservatively and 18 (75%) received dialysis treatment. Fourteen (58.3%) patients were given peritoneal dialysis (IPD) and 4 (16.66%) receivedhaemodialysis (HD). Twenty (83.33%) patients were cured completely and 2 patients (8.3%) were discharged with risk bond (DORB) and 2 patients (8.3%) died. Reversal of normal renal function was observed between 2 to 6 weeks. It is concluded that rhabdomyolysis may lead to acute renalfailure and prognosis is good if adequate treatment is administered early including dialysis therapy.