Shahbazov Rauf, Fox Michael, Alejo Jennifer L, Anjum Malik A, Azari Feredun, Doyle Alden, Agarwal Avinash, Brayman Kenneth L
Department of Surgery, University of Virginia, PO Box 800709, Charlottesville, VA 22908-0709, USA.
School of Medicine, University of Virginia, PO Box 800709, Charlottesville, VA 22908-0709, USA.
J Surg Case Rep. 2018 Apr 30;2018(4):rjy078. doi: 10.1093/jscr/rjy078. eCollection 2018 Apr.
Rhabdomyolysis is characterized by muscle cell death which can result in acute kidney injury from pigment nephropathy. We present a patient who developed rhabdomyolysis immediately after deceased donor kidney transplantation surgery and was managed with continuous renal replacement therapy that resulted in successful salvage of the kidney allograft. Patients who develop acute kidney failure requiring renal replacement therapy generally have a poor prognosis. It is worth noting that while continuous veno-venous hemofiltration (CVVHF) offers greater volume support and continuous clearance compared to hemodialysis (HD), recent studies have demonstrated no clinically significant improvement in clinical outcome between the two. Perhaps CVVHF is a better modality compared to HD in this setting to prevent further insult from pigment nephropathy to an allograft. A combination of early diagnosis and intensive continuous renal replacement therapy can be used for allograft salvage in a patient with rhabdomyolysis in the immediate post-kidney transplant period.
横纹肌溶解症的特征是肌肉细胞死亡,这可能导致色素性肾病引起急性肾损伤。我们报告一名患者,该患者在 deceased 供体肾移植手术后立即发生横纹肌溶解症,并接受了持续肾脏替代治疗,成功挽救了移植肾。发生急性肾衰竭需要肾脏替代治疗的患者通常预后较差。值得注意的是,虽然与血液透析(HD)相比,持续静脉-静脉血液滤过(CVVHF)提供了更大的容量支持和持续清除能力,但最近的研究表明,两者在临床结局上没有临床显著改善。在这种情况下,与 HD 相比,CVVHF 可能是一种更好的方式,以防止色素性肾病对移植肾造成进一步损害。早期诊断和强化持续肾脏替代治疗相结合可用于肾移植术后即刻发生横纹肌溶解症患者的移植肾挽救。