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Rhabdomyolysis

Última revisión: 20 八月 2025
Última actualización: 02 十一月 2022

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • recent crush injury
  • prolonged immobilisation
  • presence of other risk factors
  • muscular pain or weakness
Todos los datos

Otros factores de diagnóstico

  • general malaise
  • dark urine
  • muscular swelling
  • muscular tenderness
  • diminished peripheral pulse
  • prolonged capillary refill
Todos los datos

Factores de riesgo

  • trauma
  • alcohol
  • cocaine
  • amfetamine
  • phencyclidine
  • narcotics
  • diuretics
  • statins
  • salicylate toxicity
  • toxins
  • envenomation
  • inflammatory disorders
  • muscle hypoxia
  • genetic disorders
  • metabolic disorders
  • infection
  • increased body temperature
  • antipsychotics
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • serum creatine kinase (CK) level
  • serum electrolytes
  • renal function
  • liver function
  • FBC
  • coagulation studies
  • urine dipstick
  • urine microscopy
  • myoglobin levels
Todos los datos

Pruebas diagnósticas que deben considerarse

  • muscle biopsy
  • thyroid-stimulating hormone
  • erythrocyte sedimentation rate
  • antinuclear antibodies
  • toxicology screen
Todos los datos

Algoritmo de tratamiento

Agudo

crush injury and/or creatine kinase >5 times normal or >1000 IU/L

acute kidney injury refractory to initial therapy

Colaboradores

Autores

Chinmay Patel, MD, FASN

Nephrology Specialist

East Texas Kidney Specialists

Longview

TX

Divulgaciones

CP is an author of one reference cited in this topic.

Aditya Kadiyala, MD, MPH

Vice Chair

Department of Medicine

Division of Nephrology

University of Maryland

Charles Regional Medical Center

La Plata

MD

Divulgaciones

AK declares that he has no competing interests.

Agradecimientos

Dr Chinmay Patel and Dr Aditya Kadiyala would like to gratefully acknowledge Dr Mark Shapiro, Dr Courtney Sommer, and Dr Robert D. Mathis, previous contributors to this topic.

Divulgaciones

MS is an author of references cited in this topic. CS and RDM declare that they have no competing interests.

Revisores por pares

Timothy Albertson, MD, PhD, MPH

Chief

Division of Pulmonary and Critical Care Medicine

University of California, Davis

Sacramento

CA

Divulgaciones

TA declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Kodadek L, Carmichael Ii SP, Seshadri A, et al. Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document. Trauma Surg Acute Care Open. 2022;7(1):e000836.Texto completo  Resumen

The Renal Association (UK). Clinical practice guideline: acute kidney injury (AKI). Aug 2019 [internet publication].Texto completo

Sawhney JS, Kasotakis G, Goldenberg A, et al. Management of rhabdomyolysis: a practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg. 2022 Jul;224(1 pt a):196-204.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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