NEPHROLOGY, DIALYSIS AND INTERNAL MEDICINE, WARSAW MEDICAL UNIVERSITY, WARSAW, POLAND.
Wiad Lek. 2020;73(11):2543-2548.
Rhabdomyolysis is a condition characterized by muscle damage and the release of intracellular muscle contents into the circulation. It leads to a lot of complications e.g. hyperkalemia, hyperphosphatemia, and calcium disorders. The etiology is multifactorial. Severity ranges from mildly muscle weakness without any systemic complications, to life-threatening multi-organ damage. The most common and serious systemic complication is acute kidney injury (AKI). In the review, we address the epidemiology, causes, and treatment. The ideal would be to predict and prevent rhabdomyolysis at all, but when it is impossible, the key to successful treatment is its rapid implementation. Therapy should be selected individually, adapting to the triggers, and closely monitoring the patient's condition. Early implementation of fluid therapy appears to be crucial. Electrolyte disturbances should always be detected in the early stages and carefully treated. The use of bicarbonates or diuretics may also be helpful, but especially in the latter case, the indications should be well evaluated, remembering to avoid hypovolemia. Renal replacement therapy is often implemented due to water-electrolyte or acid-base disorders. Proper diagnosis and early therapy implementation improve patient outcomes, in particular in the face of new infectious dangers and global underestimating of the disease.
横纹肌溶解症是一种以肌肉损伤和细胞内肌肉成分释放到循环中为特征的疾病。它会导致许多并发症，如高钾血症、高磷血症和钙代谢紊乱。病因是多因素的。严重程度从轻度肌肉无力无任何全身并发症到危及生命的多器官损伤不等。最常见和最严重的全身并发症是急性肾损伤（AKI）。在综述中，我们讨论了流行病学、病因和治疗。理想情况下，应该预防横纹肌溶解症的发生，但当这不可能时，成功治疗的关键是迅速实施治疗。治疗应个体化选择，适应触发因素，并密切监测患者的病情。早期实施液体疗法似乎至关重要。应尽早发现电解质紊乱并谨慎治疗。碳酸氢盐或利尿剂的使用也可能有帮助，但特别是在后一种情况下，应仔细评估适应证，避免发生低血容量。由于水-电解质或酸碱平衡紊乱，常需要进行肾脏替代治疗。正确的诊断和早期治疗实施可改善患者的预后，尤其是在面临新的传染性危险和全球低估该疾病的情况下。
