Abstract
Rhabdomyolisis is muscle cell lysis (as hemolysis is lysis of red blood cells) with liberation of cell content into the circulation. As hemolysis liberates hemoglobin, rhabdomyolysis liberates myoglobin. The occurrence of myoglobinuria indicates extensive destruction of striated muscle, that is, the damage of at least 200 grams of normal muscles [1]. That is why myoglobinuria is not prominent after myocardial infarction.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Berenbaum MC, Birch CA, Moreland JD. Paroxysmal myoglobinuria. Lancet 1: 892–895, 1953.
Rowland LP, Penn AS. Myoglobinuria. Med Clin North Am 56: 1233–1256, 1972.
Gabow PA, Kaehny WD, Kelleher SP. The spectrum of rhabdomyolysis. Medicine 61: 141–152, 1982.
Kagen LJ, Christian CL. Immunologic measurements of myoglobin in human adult and fetal skeletal muscle. Am J Physiol 211: 656–660, 1966.
Kagen LJ, Gurewich R. Localization of myoglobin in human skeletal muscle using fluorescent antibody technique. J Histochem Cytochem 15: 436–441, 1967.
Kagen LJ, Linder S. Biosynthesis of myoglobin by muscle polysomes. Biochim Biophys Acta 195: 522–530, 1969.
Knochel JP: Rhabdomyolysis and myoglobinuria. Ann Rev Med 33: 435–443, 1982.
Hallgren R, Karlsson FA, Roxin LE, Venge P. Myoglobin turnover: Influence of renal and extrarenal factors. J Lab Clin Med 91: 246–254, 1978.
Hart PM, Feinfeld DA, Briscoe AM, Nurse HM, Hotchkiss JL, Thomson GE. The effect of renal failure and hemodialysis on serum and urine myoglobin. Clin Nephrol 18: 141–143, 1982.
Kuroda M, Katsuki K, Uehara H, Kita T, Asaka S, Miyazaki R, Akiyama T, Tofuku Y, Takeda R. Successful treatment of fulminating complications associated with extensive rhabdomyolysis by plasma exchange. Artif Organs 5: 372–378, 1981.
Kagen LJ. Myoglobin: Biochemical, Physiological and Clinical Aspects. New York: Columbia University Press, 1973.
Olerud JE, Homer LD, Carroll HW. Serum myoglobin levels predicted from serum enzyme values. N Engl J Med 293: 483–485, 1975.
de Wardener. The Kidney. Edinburgh: Churchill Livingstone. 1973.
Grossman RA, Hamilton RW, Morse BM, Penn AS, Goldberg M. Nontraumatic rhabdomyolysis and acute renal failure. N Engl J Med 291: 807–811, 1974.
Van Der Veen KJ, Willibrands AF. Isoenzymes of creatine phosphokinase in tissue extracts and in normal and pathological sera. Clin Chim Acta 12: 312–316, 1966.
Soffer O, Fellner SK, Rush RL. Creatine phosphokinase in long-term dialysis patients. Arch Intern Med 141: 181–183, 1981.
Fitch CD, Lucy DD, Bornhofen JH, Dalrymple GV. Creatine metabolism in skeletal muscle. II. Creatine kinetics in man. Neurology 18: 32–42, 1968.
Knochel JP, Dotin LN, Hamburger RJ. Heat stress, exercise and muscle injury: Effects on urate metabolism and renal function. Ann Intern Med 81: 321–328, 1974.
Crim MC, Calloway DH, Margen S. Creatine metabolism in men: Urinary creatine and creatinine excretions with creatine feeding. J Nutr 105: 428–438, 1975.
Mitch WE, Collier VU, Walser M. Creatinine metabolism in chronic renal failure. Clin Sci 58: 327–335, 1980.
Crim MC, Calloway DH, Margen S. Creatine metabolism in men: Creatine pool size and turnover in relation to creatine intake. J Nutr 106: 471–481, 1976.
Lazdins O, Dawson JK. Concentration of guanidines in normal human plasma. Clin Exp Pharmacol Physiol 5: 75–80, 1978.
Jones JD, Burnett PC. Creatinine metabolism in humans with decreased renal function: Creatinine deficit. Clin Chem 20: 1204–1212, 1974.
Jones JD, Burnett PC. Creatinine metabolism and toxicity. Kidney Int 7: S294–S298, 1975.
Andreucci VE, Dal Canton A, Usberti M, Federico S, Calderaro V, Cianciaruso B, Russo D, Balletta M, Sabbatini M, Capuano A. Posttraumatic acute renal failure: Clinical experience after the earthquake in southern Italy. In Acute Renal Failure, Seybold D, Gessler U (eds). Basel: Karger, 1982, pp. 219–239.
Koffler A, Friedler RM, Massry SG. Acute renal failure due to nontraumatic rhabdomyolysis. Ann Intern Med 85: 23–28, 1976.
Hamilton RW, Gardner LB, Penn AS, Goldberg M. Acute tubular necrosis caused by exercise-induced myoglobinuria. Ann Intern Med 77-82, 1972.
Knochel JP: Renal injury in muscle disease. In The Kidney in Systemic Disease, Suki WN, Eknoyan G (eds). New York: John Wiley, 1976, pp. 129–140.
Swenson RS, Pellascio ML, Spreiter SC. Evidence that creatinine generation is not increased in experimental rhabdomyolysis acute renal failure. Abstracts Am Soc Nephrol, 12th Meeting, Boston, 1979, p 7A.
Hays RM. Dynamics of body water and electrolytes. In Clinical disorders of fluid and electrolyte metabolism, Maxwell MH, Kleeman CR (eds). New York: McGraw-Hill, 1980 (3rd ed), pp 1–36.
Akmal M, Goldstein DA, Telfer N, Wilkinson E, Massry SG. Resolution of muscle calcification in rhabdomyolysis and acute renal failure. Ann Intern Med 89: 928–930, 1978.
Akmal M, Valdin JR, McCarron MM, Massry SG. Rhabdomyolysis with and without acute renal failure in patients with phencyclidine intoxication. Am J Nephrol 1: 91–96, 1981.
Warren DJ, Leitch AG, Leggett RJ. Hyperuricemic acute renal failure after epileptic seisures. Lancet 2: 385–387, 1975.
Smith RF. Exertional rhabdomyolysis in naval officer candidates. Ann Intern Med 121: 313–319, 1968.
Schiff HB, MacSearraigh ETM, Kallmeyer JC. Myoglobinuria, rhabdomyolysis and marathon running. Quart J Med 47: 463–472, 1978.
MacSearraigh ETM, Kallmeyer JC, Schiff HB. Acute renal failure in marathon runners. Nephron 24: 236–240, 1979.
Diamond I, Aquino TI. Myoglobinuria following unilateral status epilepticus and ipsilateral rhabdomyolysis. N Engl J Med 272: 834–837, 1965.
Selzer ML, Reinhart MJ, Deeney JM. Acute renal failure following EST. Ann J Psychiat 120: 602–603, 1963.
Bywaters EGL, Beall D: Crush injuries with impairment of renal function. Brit Med J 1: 427–432, 1941.
Whelton A, Donadio JV Jr. Post-traumatic acute renal failure in Vietnam. A comparison with the Korean War experience. Johns Hopkins Med J 124: 95–105, 1969.
Whelton A. Post-traumatic acute renal failure. Bull N Y Acad Med 55: 150–162, 1979.
Owen CA, Mubarak SJ, Hargens AR, Rutherford L, Garetto LP, Akeson WH. Intramural pressures with limb compression. Clarification of the pathogenesis of drug-induced muscle-compartment syndrome. N Engl J Med 300: 1169, 1979.
Schreiber SN, Liebowitz MR, Bernstein LH, Srinivasan K. Limb compression and renal impairment (crush syndrome) complicating narcotic overdose. N Engl J Med 284: 368–369, 1971.
Penn AS, Rowland LP, Fraser DW. Drugs, coma, and myoglobinuria. Arch Neurol 26: 336–343, 1972.
Haimovici H. Arterial embolism, myoglobinuria and renal tubular necrosis. Arch Surg 100: 639–645, 1970.
Kagen LJ. Immunologic detection of myoglobinuria after cardiac surgery. Ann Intern Med 67: 1183–1189, 1967.
Gordon BS, Newman W. Lower nephron syndrome following prolonged knee-chest position. J Bone Joint Surg 35A: 764–768, 1953.
Mubarak S, Owen CA. Compartmental syndrome and its relation to the crush syndrome: A spectrum of disease. Clin Orthop 113: 81–89, 1975.
Getzen LC, Carr JE. Etiology of anterior tibial compartment syndrome. Surg Gynec Obstet 125: 347–350, 1967.
Eiser AR, Neff MS, Slifkin RF. Acute myoglobinuric renal failure. A consequence of the neuroleptic malignant syndrome. Arch Intern Med 142: 601–603, 1982.
Richter RW, Challenor YB, Pearson J, Kagen LJ, Hamilton LL, Ramsey WH. Acute myoglobinuria associated with heroin addiction. JAMA 216: 1172–1176, 1971.
Robinson SF, Woods AH. Heroin induced rhabdomyolysis and acute renal failure. A case report. Ariz Med 31: 246–251, 1974.
Marshall RJ, McCanghey WTE. Hypothermic myxedema coma with muscle damage and acute renal tubular necrosis. Lancet 2: 754–757, 1956.
Vertel RM, Knochel JP. Acute renal failure due to heat injury Am J Med 43: 435–451, 1967.
Reid HA. Myoglobinuria and sea snake-bite poisoning. Brit Med J 1: 1284–1289, 1961.
Heitzman EJ, Patterson JF, Stanley MM. Myoglobinuria and hypokalemia in regional enteritis. Arch Intern Med 110: 117–124, 1962.
Campion DS, Arias JM, Carter NW. Rhabdomyolysis and myoglobinuria. Association with hypokalemia of renal tubular acidosis. JAMA 220: 967–969, 1972.
Knochel JP, Schlein EM. On the mechanism of rhabdomyolysis in potassium depletion. J Clin Invest 51: 1750–1758, 1972.
Nadel SM, Jackson JW, Ploth DW. Hypokalemic rhabdomyolysis and acute renal failure. Occurrence following total parenteral nutrition. JAMA 241: 2294–2296, 1979.
Gross EG, Dexter JD, Roth RG. Hypokalemic myopathy with myoglobinuria associated with licorice ingestion. N Engl J Med 274: 602–606, 1966.
Mohamed SD, Chapman RS, Crooks J. Hypokalemia, flaccid quadriparesis and myoglobinuria with carbenoxolone (biogastrone). Brit Med J 1: 1581–1582, 1966.
Mitchell ABS. Duagastrone-induced hypokalemic nephropathy and myopathy with myoglobinuria. Postgrad Med J 47: 807–813, 1971.
Barnes PC, Leonard JHC. Hypokalemic myopathy and myoglobinuria due to carbenoxolone sodium. Postgrad Med J 47: 813–815, 1971.
Drutz DJ, Fan JH, Tai TY. Hypokalemic rhabdomyolysis and myoglobinuria following amphotericin B therapy. JAMA 211: 824–826, 1970.
Pirovino M, Neff MS, Sharon E. Myoglobinuria and acute renal failure with acute polymyositis. N Y State J Med 79: 764–767, 1979.
Simon NM, Rovner RN, Berlin BS. Acute myoglobinuria associated with type A2 (Hong Kong) influenza. JAMA 212: 1704–1705, 1970.
Minow RA, Gorbach S, Johnson BL, Dornfeld L. Myoglobinuria associated with influenza A infection. Ann Intern Med 80: 359–361, 1974.
Fitzgerald F. Clinical hypophosphatemia. Ann Rev Med 29: 177–189, 1978.
Kjellmer I. The potassium ion as a vasodilator during muscular exercise. Acta Physiol Scand 63: 460–468, 1963.
Knochel JP, Barcenas C, Cotton JR, Fuller TJ, Haller R, Carter NW. Hypophosphatemia and rhabdomyolysis. J Clin Invest 62: 1240–1246, 1978.
Knochel JP. The pathophysiology and clinical characteristic of severe hypophosphatemia. Arch Intern Med 137: 203, 1977.
Knochel JP. Serum calcium derangements in rhabdomyolysis. N Engl J Med 305: 161–163, 1981.
Publicover SJ, Duncan CJ, Smith JL. The use of A23187 to demonstrate the role of intracellular calcium in causing ultrastructural damage in mammalian muscle. J Neuropathol Exp Neurol 37: 544–557, 1978.
Reddy MK, Etlinger JD, Rabinowitz M, Fischman DA, Zak R. Removal of Z-lines and α-actinin from isolated myofibrils by a calcium-activated neutral protease. J Biol Chem 250: 4278–4284, 1975.
Llach F, Felsenfeld AJ, Haussler MR. The pathophysiology of altered calcium metabolism in rhabdomyolysis-induced acute renal failure. N Engl J Med 305: 117–123, 1981.
Adams EC. Differentiation of myoglobin and hemoglobin in biological fluids. Ann Clin Lab Sci 10: 493–499, 1980.
Anderson RJ, Linas SL, Berns AS, Henrich WL, Miller TR, Gabow PA, Schrier RW. Nonoliguric acute renal failure. N Engl J Med 296: 1134–1138, 1977.
Hofbauer KG, Forgiarini P, Imbs F, Wood JM. Effects of a competitive vasopressin antagonist in glycerol-induced acute renal failure in rats. In Acute Renal Failure, Eliahou HE (ed). London: John Libbey, 1982, pp. 194–198.
Perri GC, Gorini P. Uremia in the rabbit after injection of crystalline myoglobin. Brit J Exp Pathol 33: 440–444, 1953.
Braun SR, Weiss FR, Keller AI, Ciccone JR, Preuss HG. Evaluation of the renal toxicity of heme proteins and their derivatives: A role in the genesis of acute tubular necrosis. J Exp Med 131: 443–460, 1970.
Editorial. Acute renal failure, hyperuricemia and myoglobinuria. Brit Med J 1: 1233-1234, 1979.
Meroney WH, Herndon RF. The management of acute renal insufficiency. JAMA 155: 877–883, 1954.
Meroney WH, Arney GK, Segar WE, Balch HH. The acute calcification of traumatized muscle, with particular reference to acute post-traumatic renal insufficiency. J Clin Invest 36: 825–832, 1956.
Pietrek J, Kokot F, Kuska J. Serum 25-hydroxyvitamin D and parathyroid hormone in patients with acute renal failure. Kidney Int 13: 178–185, 1978.
Gray RW, Wilz DR, Caldas AE, Lemann J Jr. The importance of phosphate in regulating plasma 1,25 (OH)2 vitamin D levels in humans: Studies in healthy subjects in calcium-stone formers and in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 45: 299–306, 1977.
Massry SG, Arieff AI, Coburn JW, Palmieri G, Kleeman CR. Divalent ion metabolism in patients with acute renal failure: Studies on the mechanism of hypocalcemia. Kidney Int 5: 437–445, 1974.
Massry SG, Stein R, Garty J, Arieff AI, Coburn JW, Norman AW, Friedler RM. Skeletal resistance to the calcemic action of parathyroid hormone in uremia: Role of 1,25(OH)2D3. Kidney Int 9: 467–474, 1976.
Feinstein EI, Akmal M, Telfer N, Massry SG. Delayed hypercalcemia with acute renal failure associated with nontraumatic rhabdomyolysis. Arch Intern Med 141: 753–755, 1981.
Tavill AS, Evanson JM, Baker SB, Hewitt V. Idiopathic paroxysmal myoglobinuria with acute renal failure and hypercalcemia. N Engl J Med 271: 283–287, 1964.
Segal AT, Miller M, Moses AM. Hypercalcemia during the diuretic phase of acute renal failure. Ann Intern Med 68: 1066–1068, 1968.
Leonard CD, Eichner ER. Acute renal failure and transient hypercalcemia in idiopathic rhabdomyolysis. JAMA 211: 1539–1540, 1970.
Zabetakis PM, Singh R, Michelis MF, Murdaugh HV. Acute renal failure. Bone immobilization as cause of hypercalcemia. NY State J Med 79: 1887–1891, 1979.
Weinstein RS, Hudson JB. Parathyroid hormone and 25-hydroxycholecalciferol levels in hypercalcemia of acute renal failure. Arch Intern Med 140: 410–411, 1980.
Miach PJ, Dawborn JK, Douglas MC, Jerums G, Xipell JM. Prolonged hypercalcemia following acute renal failure. Clin Nephrol 4: 32–36, 1975.
Butikofer E, Molleyres J. Akute ischamische Muskelnekrosen, reversible Muskelverkalkungen und sekundare Hypercalcemia bei akuter Anurie. Schweiz Med Woch 98: 961–965, 1968.
de Torrente A, Betl T, Cohn PD, Kawamoto E, Hertz P, Schrier RW. Hypercalcemia of acute renal failure: Clinical significance and pathogenesis. Am J Med, 61: 119–123, 1976.
Feinstein EI, Akmal M, Goldstein DA, Telfer N, Massry SG. Hypercalcemia and acute widespread calcifications during the oliguric phase of acute renal failure due to rhabdomyolysis. Mineral Electrolyte Metab 2: 193–199, 1979.
Eneas JF, Schoenfeld PY, Humphreys MH. The effect of infusion of mannitol-sodium bicarbonate on the clinical course of myoglobinuria. Arch Intern Med 139: 801–805, 1979.
Llach F, Descoeudres C, Massry SG. Heroin-associated nephropathy Clinical and histological studies in 19 patients. Clin Nephrol 11: 7–11, 1979.
Cogen FC, Rigg G, Simmons JL, Domino EF. Phencyclidine-associated acute rhabdomyolysis. Ann Intern Med 88: 210–212, 1978.
Barton CH, Sterling ML, Vaziri ND. Rhabdomyolysis and acute renal failure associated with phencyclidine intoxication. Arch Intern Med 140: 568–569, 1980.
Patel R, Das M, Patazzolo M, Ansari A, Balasubramariam S. Myoglobinuric acute renal failure in phencyclidine overdose. Report of observations in eight cases. Ann Emerg Med 9: 549–553, 1980.
Hart JB, McChesney JD, Grief M. Composition of illicit drugs and the use of drug analysis and abuse abatement. J Psychedelic Drugs 5: 83–88, 1972.
Boyd RE, Brennan PT, Deng JF, Rochester DF, Spyker DA. Strychnine poisoning. Recovery from profound lactic acidosis, hyperthermia and rhabdomyolysis. Am J Med 74: 507–512, 1983.
Bichet OD, Burke TJ, Schrier RW. Prevention and pathogenesis of acute renal failure. Clin Exper Dial Apheresis 5: 127–141, 1981.
Whelton A, Schach Von Witenau M, Twomey TM, Gordon Walker W, Bianchine JR. Doxycycline pharmacokinetics in the absence of renal function. Kidney Int 5: 365–371, 1974.
Editor information
Rights and permissions
Copyright information
© 1984 Martinus Nijhoff Publishing, Boston
About this chapter
Cite this chapter
Andreucci, V.E. (1984). Myoglobinuria and Acute Renal Failure. In: Andreucci, V.E. (eds) Acute Renal Failure. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2841-4_12
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2841-4_12
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9794-9
Online ISBN: 978-1-4613-2841-4
eBook Packages: Springer Book Archive