Khan Zahid, Ibekwe Mildred, Abumedian Mohammed, Yousif Yousif, Mlawa Gideon
Cardiology, Royal Free Hospital, London, GBR.
Internal Medicine, Barking, Havering and Redbridge University Hospitals National Health Service (NHS) Trust, London, GBR.
Cureus. 2022 Mar 26;14(3):e23511. doi: 10.7759/cureus.23511. eCollection 2022 Mar.
Renal failure secondary to rhabdomyolysis due to statins is quite rare. We present a case of a 57-year-old patient who developed acute renal failure due to rhabdomyolysis secondary to atorvastatin. Interestingly, this patient had a similar presentation 27 years ago requiring dialysis only once resulting in complete resolution of symptoms. He presented to the hospital generally feeling unwell and then developed generalized body ache. He had an extremely elevated creatinine kinase level of 116,000 and it went up to 145,000. His urine dip was negative for nitrites and was positive for blood and protein. He was commenced on intravenous fluids. He also had a computerized tomographic scan of the kidneys, ureters, and bladder, which showed some fat stranding around both kidneys likely inflammatory in origin. His creatinine level continue to rise despite intravenous fluids and was acidotic on blood gases. He also tested positive for COVID-19 on day 7 of admission and eventually needed dialysis. His renal functions improved to baseline post dialysis and kidney functions returned to normal. His autoimmune screen was negative and his renal functions remained normal on a follow-up visit.
他汀类药物引起横纹肌溶解继发的肾衰竭相当罕见。我们报告一例57岁患者,因阿托伐他汀继发横纹肌溶解而发生急性肾衰竭。有趣的是,该患者27年前有过类似表现,仅需透析一次,症状就完全缓解。他因全身不适入院,随后出现全身疼痛。他的肌酸激酶水平极高,达116,000,后来升至145,000。他的尿液试纸检测亚硝酸盐为阴性,血液和蛋白质为阳性。他开始接受静脉补液治疗。他还进行了肾脏、输尿管和膀胱的计算机断层扫描,显示双肾周围有一些脂肪条索,可能起源于炎症。尽管进行了静脉补液,他的肌酐水平仍持续升高,血气分析显示酸中毒。入院第7天他的新冠病毒检测呈阳性,最终需要透析。透析后他的肾功能恢复到基线水平,肾功能恢复正常。他的自身免疫筛查为阴性,随访时肾功能仍保持正常。