Prehospital treatment of rhabdomyolysis in people who fall

2021 ◽  
Vol 13 (7) ◽  
pp. 1-6
Author(s):  
Shane Devlin
Keyword(s):  
Skeletal Muscle ◽  
Acute Kidney Injury ◽  
Elderly People ◽  
Kidney Injury ◽  
Tissue Necrosis ◽  
International Consensus ◽  
Prehospital Treatment ◽  
Time Period ◽  
Long Time ◽  
Falls In Elderly

Of people aged 65 and older, 30% will fall at least once per year—for people aged over 80, this rises to 50%. Patients who remain on the floor for a long time are at risk of developing rhabdomyolysis. If a person cannot move or get off the floor, tissue necrosis can occur at the point of contact and skeletal muscle is destroyed, releasing its contents into the bloodstream. This can eventually lead to crush syndrome, which includes rhabdomyolysis, hyperkalemia, dysrhythmias and acute kidney injury, and can be fatal. There are no guidelines for a time period when rhabdomyolysis is more likely to occur nor international consensus on how to best treat this condition in and out of hospital. This article looks at rhabdomyolysis resulting from falls in elderly people, and how to recognise and manage it. The aim is to improve awareness of rhabdomyolysis among prehospital practitioners so they can improve its management and advise patients at home.

scholarly journals SP198EPIDEMIOLOGICAL PROFILE OF INTRA HOSPITAL DIALYTICAL ACUTE KIDNEY INJURY. THE EXPERIENCE OF A PRIVATE HEALTH CARE PROVIDER, SPECIALIST IN CUSTOMER SERVICE IN ELDERLY PEOPLE IN BRAZIL, IN 2016

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i411-i411
Author(s):  
Sergio Dias da Silveira Junior ◽  
Anderson Alvarenga Nascimento ◽  
Cristiano Nascimento ◽  
Eduardo Parrilo ◽  
Felipe Padovani
Keyword(s):  
Health Care ◽  
Acute Kidney Injury ◽  
Elderly People ◽  
Customer Service ◽  
Health Care Provider ◽  
Care Provider ◽  
Kidney Injury ◽  
Private Health Care

Diagnosis of oliguria and acute kidney injury

2016 ◽  
Author(s):  
John A. Kellum
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Extracellular Volume ◽  
Kidney Injury ◽  
Clinical Problem ◽  
Clinical Syndrome ◽  
Volume Depletion ◽  
International Consensus ◽  
Tubular Necrosis ◽  
Diagnosis And Classification

Diagnosis and classification of acute pathology in the kidney is major clinical problem. Azotemia and oliguria represent not only disease, but also normal responses of the kidney to extracellular volume depletion or a decreased renal blood flow. Clinicians routinely make inferences about both the presence of renal dysfunction and its cause. Pure prerenal physiology is unusual in hospitalized patients and its effects are not necessary benign. Sepsismay alter renal function without the characteristic changes in urine indices. The clinical syndrome known as acute tubular necrosis does not actually manifest the histological changes that the name implies. Acute kidney injury (AKI) is a term proposed to encompass the entire spectrum of the syndrome from minor changes in renal function to a requirement for renal replacement therapy. Criteria based on both changes in serum creatinine and urine output represent a broad international consensus for diagnosing and staging AKI.

scholarly journals MP271IMPORTANCE OF SKELETAL MUSCLE MASS ON THE LONG TERM SURVIVAL IN ELDERLY ACUTE KIDNEY INJURY PATIENTS WHO UNDERWENT CONTINUOUS RENAL REPLACEMENT THERAPY

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii527-iii527
Author(s):  
Ihm Soo Kwak ◽  
Harin Rhee ◽  
Il-Young Kim ◽  
Sang-Heon Song ◽  
Eun-Young Seong ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Kidney Injury ◽  
Term Survival

Acute Kidney Injury

2010 ◽  
Vol 21 (4) ◽  
pp. 350-356
Author(s):  
Rhonda K. Martin
Keyword(s):  
Acute Kidney Injury ◽  
Patient Outcomes ◽  
Kidney Injury ◽  
Common Disease ◽  
International Consensus ◽  
Mortality And Morbidity ◽  
Consensus Statements ◽  
Clinical Tools ◽  
Definition Of ◽  
Significant Mortality

Acute kidney injury (AKI) is a common disease in the acutely ill patient population, as a singular diagnosis or a complication of sepsis, causing significant mortality and morbidity. Progress in diagnosis, treatment, and research in AKI has been limited by the lack of a universally accepted clinical definition. The clinical definition of AKI onset and progression, early diagnostic indicators, and understanding the unique pathophysiology of AKI are requisite to early treatment and management and ultimately positive patient outcomes. This article reviews the advances in defining and staging AKI on the basis of international consensus statements. An update on the most recent concepts affecting renal pathophysiology in AKI is also presented. Current clinical tools used in diagnosing and monitoring AKI, including the development of renal biomarkers, are discussed.

scholarly journals Incidence and Risk Factors for Early Acute Kidney Injury in Nonsurgical Patients: A Cohort Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Javier Enrique Cely ◽  
Elkin José Mendoza ◽  
Carlos Roberto Olivares ◽  
Oscar Julián Sepúlveda ◽  
Juan Sebastián Acosta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Stay ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Epidemiological Data ◽  
Hospital Death ◽  
Prehospital Treatment ◽  
Nephrotoxic Drugs ◽  
Nonsurgical Patients

Introduction. Detecting acute kidney injury (AKI) in the first days of hospitalization could prevent potentially fatal complications. However, epidemiological data are scarce, especially on nonsurgical patients.Objectives. To determine the incidence and risk factors associated with AKI within five days of hospitalization (EAKI).Methods. Prospective cohort of patients hospitalized in the Internal Medicine Department.Results. A total of 16% of 400 patients developed EAKI. The associated risk factors were prehospital treatment with nephrotoxic drugs (2.21 OR; 95% CI 1.12–4.36,p=0.022), chronic kidney disease (CKD) in stages 3 to 5 (3.56 OR; 95% CI 1.55–8.18,p<0.003), and venous thromboembolism (VTE) at admission (5.05 OR; 95% CI 1.59–16.0,p<0.006). The median length of hospital stay was higher among patients who developed EAKI (8 [IQR 5–14] versus 6 [IQR 4–10],p=0.008) and was associated with an increased requirement for dialysis (4.87 OR 95% CI 2.54 to 8.97,p<0.001) and in-hospital death (3.45 OR; 95% CI 2.18 to 5.48,p<0.001).Conclusions. The incidence of EAKI in nonsurgical patients is similar to the worldwide incidence of AKI. The risk factors included CKD from stage 3 onwards, prehospital treatment with nephrotoxic drugs, and VTE at admission. EAKI is associated with prolonged hospital stay, increased mortality rate, and dialysis requirement.

scholarly journals Contrast Medium-Induced Acute Kidney Injury

2015 ◽  
Vol 5 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Umar Sadat ◽  
Ammara Usman ◽  
Jonathan R. Boyle ◽  
Paul D. Hayes ◽  
Richard J. Solomon
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Medium ◽  
Kidney Injury ◽  
Diagnostic Methods ◽  
High Yield ◽  
Western World ◽  
Ageing Population ◽  
International Consensus ◽  
Randomised Controlled ◽  
Meta Analyses

Contrast medium-induced acute kidney injury (CI-AKI) is a predominant cause of hospital-acquired renal insufficiency. With an increasing number of contrast medium-enhanced radiological procedures being performed in a rapidly increasing ageing population in the Western world, it is imperative that more attention is given to understand the aetiology of CI-AKI to devise novel diagnostic methods and to formulate effective prophylactic and therapeutic regimens to reduce its incidence and its associated morbidity and mortality. This article presents high-yield information on the above-mentioned aspects of CI-AKI, primarily based on results of randomised controlled trials, meta-analyses, systematic reviews and international consensus guidelines.

scholarly journals Resuscitation with PEGylated carboxyhemoglobin preserves renal cortical oxygenation and improves skeletal muscle microcirculatory flow during endotoxemia

2020 ◽  
Vol 318 (5) ◽  
pp. F1271-F1283 ◽  
Author(s):  
Philippe Guerci ◽  
Bülent Ergin ◽  
Aslı Kandil ◽  
Yasin Ince ◽  
Paul Heeman ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Acute Kidney Injury ◽  
Plasma Levels ◽  
Kidney Injury ◽  
Albino Rats ◽  
Heme Oxygenase 1 ◽  
Animal Group ◽  
Phosphorescence Quenching ◽  
Time Control ◽  
Microcirculatory Flow

PEGylated carboxyhemoglobin (PEGHbCO), which has carbon monoxide-releasing properties and plasma expansion and oxygen-carrying properties, may improve both skeletal microcirculatory flow and renal cortical microcirculatory Po2 (CµPo2) and, subsequently, limit endotoxemia-induced acute kidney injury. Anesthetized, ventilated Wistar albino rats ( n = 44) underwent endotoxemic shock. CµPo2 was measured in exposed kidneys using a phosphorescence-quenching method. Rats were randomly assigned to the following five groups: 1) unresuscitated lipopolysaccharide (LPS), 2) LPS + Ringer’s acetate (RA), 3) LPS + RA + 0.5 µg·kg·−1min−1 norepinephrine (NE), 4) LPS + RA + 320 mg/kg PEGHbCO, and 5) LPS + RA + PEGHbCO + NE. The total volume was 30 mL/kg in each group. A time control animal group was used. Skeletal muscle microcirculation was assessed by handheld intravital microscopy. Kidney immunohistochemistry and myeloperoxidase-stained leukocytes in glomerular and peritubular areas were analyzed. Endotoxemia-induced histological damage was assessed. Plasma levels of IL-6, heme oxygenase-1, malondialdehyde, and syndecan-1 were assessed by ELISA. CµPo2 was higher in the LPS + RA + PEGHbCO-resuscitated group, at 35 ± 6mmHg compared with 21 ± 12 mmHg for the LPS+RA group [mean difference: −13.53, 95% confidence interval: (−26.35; −0.7156), P = 0.035]. The number of nonflowing, intermittent, or sluggish capillaries was smaller in groups infused with PEGHbCO compared with RA alone ( P < 0.05), while the number of normally perfused vessels was greater ( P < 0.05). The addition of NE did not further improve CµPo2 or microcirculatory parameters. Endotoxemia-induced kidney immunohistochemistry and histological alterations were not mitigated by PEGHbCO 1 h after resuscitation. Renal leukocyte infiltration and plasma levels of biomarkers were similar across groups. PEGHbCO enhanced CµPo2 while restoring skeletal muscle microcirculatory flow in previously nonflowing capillaries. PEGHbCO should be further evaluated as a resuscitation fluid in mid- to long-term models of sepsis-induced acute kidney injury.

scholarly journals Factors Affecting Inpatient Mortality in Elderly People with Acute Kidney Injury

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Muhammad Abdul Mabood Khalil ◽  
Safia Awan ◽  
Rabeea Azmat ◽  
Muhammad Ashhad Ullah Khalil ◽  
Nazish Naseer ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Elderly People ◽  
Kidney Injury ◽  
Hemodynamic Instability ◽  
Stage I ◽  
Stage Ii ◽  
University Hospital ◽  
Stage Iii ◽  
Inpatient Mortality ◽  
Factors Associated

Background. Acute Kidney Injury (AKI) is common in elderly people (EP). There is paucity of data on predictor of mortality in EP with AKI. Objective. This study was done to know more about factors associated with inpatient mortality in EP with AKI. Methods. We retrospectively reviewed medical records of patients aged 65 years or above hospitalized with a diagnosis of AKI at Aga Khan University Hospital, Karachi, between January 2005 and December 2010. Binary logistic regression models were constructed to identify factors associated with mortality in EP with AKI. Results. 431 patients had AKI, with 341 (79.1%) having stage I AKI, 56 (13%) having stage II AKI, and 34 (7.9%) having stage III AKI. Out of 431 patients, 142 (32.9%) died. Mortality increased with increasing severity of AKI. Mortality was 50% (17/34) in AKI stage III, 44.6% (25/56) in AKI stage II, and 29.3% (100/341) in AKI stage I. Factors associated with increased inpatients mortality were presence of stage III AKI (OR: 3.20, P=0.04, 95% CI: 1.05–9.72), presence of oliguria (OR: 3.42, P=0.006, 95% CI: 1.42–8.22), and need for vasopressors (OR: 6.90, P<0.001, 95% CI: 2.42–19.65). Median bicarbonate 18 versus 17 between those who survived and those who died was associated with less mortality (OR: 0.94, P=0.02, 95% CI: 0.89–0.99). History of hypertension (OR: 0.49, P=0.03, 95% CI: 0.25–0.95) and high admission creatinine (OR: 0.68, P=0.01, 95% CI: 0.50–0.91) were also associated with less mortality. Conclusion. Mortality in EP increases with increasing severity of AKI. Presence of stage III AKI, oliguria, and hemodynamic instability needing vasopressor are associated with increased mortality. Increased median bicarbonate, presence of hypertension, and high admission creatinine were various factors associated with decreased inpatient mortality. Increasing age and need for dialysis did not increase mortality in elderly population.

scholarly journals Skeletal Muscle Resistance to Leucine Induced Signal Transduction and Regulation of Autophagy in Acute Kidney Injury (AKI)

2012 ◽  
Vol 26 (S1) ◽  
Author(s):  
Kevin McIntire ◽  
Yu Chen ◽  
Sumita Sood ◽  
Ralph Rabkin
Keyword(s):  
Skeletal Muscle ◽  
Signal Transduction ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Induced Signal

An Unusual Cause of Myoglobinuria

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Skeletal Muscle ◽  
Acute Kidney Injury ◽  
Lactate Dehydrogenase ◽  
Physical Therapy ◽  
Muscle Cell ◽  
Rare Case ◽  
Creatine Phosphokinase ◽  
Kidney Injury ◽  
Acute Rhabdomyolysis ◽  
Specific Muscle

Rhabdomyolysis is characterized by the acute breakdown of skeletal muscle, resulting in the release of muscle cell contents like myoglobin, creatine phosphokinase (CK) and lactate dehydrogenase, which can lead to acute kidney injury in severe cases. A number of etiologies have been identified in acute rhabdomyolysis including hereditary and acquired of which drugs and trauma account for the majority of cases [1]. Physical therapy is frequently prescribed and generally considered safe for weakness; deconditioning and non - specific muscle aches. Rhabdomyolysis following a massage session is unheard of. However we report a rare case of rhabdomyolysis with acute kidney injury following an aggressive massage session.

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