Utility of Serum Creatinine, Creatine Kinase and Urinary Myoglobin in Detecting Acute Renal Failure due to Rhabdomyolysis in Trauma and Electrical Burns Patients
Journal Title: The Indian Journal of Surgery - Year 2013, Vol 75, Issue 1
Abstract
Rhabdomyolysis due to trauma and burns is an important cause of acute renal failure (ARF) secondary to myoglobinuria. To prevent morbidity and mortality from ARF due to rhabdomyolysis, early detection of ARF by monitoring the biochemical parameters such as serum creatinine, serum creatine kinase (CK), and urinary myoglobin (UM) can be helpful. The aims of the study were (1) to detect ARF due to rhabdomyolysis using serum creatinine, serum CK, and UM in trauma and electrical burn patients (2) to compare utility of these parameters in early prediction of ARF in patients of rhabdomyolysis. A total of 50 patients with trauma and electrical burns were included in the study. Serum creatinine, serum CK, and UM measurements were done at the time of admission and after 48 h. Diagnosis of ARF was made in the patients by Rifle’s criteria. The presence of significant elevation of creatinine, serum CK, and UM at the time of admission and after 48 h was compared in patients developing ARF by Fisher’s exact test. Fifteen of the 50 patients developed ARF as per the defined criteria. Of these, 9 patients (60 %) had raised level of serum creatinine above 1.4 mg% at admission and 14 patients (93.33 %) had CK level >1250 U/L at admission, whereas UM was positive in 6 (40 %) patients. Serum creatinine was significantly raised in all of the 15 ARF patients (100 %) after 48 h of admission and serum CK was raised in 14 of the 15 ARF patients (93.33 %). UM was negative in all the patients after 48 h of admission. Statistical analysis showed that rise in serum CK on admission was significantly increased in patients developing ARF as compared with serum creatinine and UM (P < 0.0001). On admission, CK is a better predictor of ARF due to rhabdomyolysis than creatinine and UM. Initial creatinine is a better predictor of ARF due to rhabdomyolysis than UM. UM assay is not a good investigation for early prediction of ARF in rhabdomyolysis.
Authors and Affiliations
Preetish Bhavsar, Kirtikumar Jagdish Rathod, Darshana Rathod, C. S. Chamania
Keywords
Related Articles
- EP ID EP679867
- DOI 10.1007/s12262-012-0451-6
- Views 48
- Downloads 0
Crohn’s Perforation: Not so Uncommon in the Indian Population
Crohn’s Disease is a chronic, idiopathic, transmural inflammatory disease affecting predominantly distal ileum, the common presentation include stricture and fistula formation. Free perforation in the peritoneal...
Torsion of Wandering Spleen in a Woman Presenting as Emergency
Wandering spleen is a very rare condition, it is characterized by the absence or weakness of one or more of the ligaments that hold the spleen in its normal position in the left hypochondrium. The disorder is not genetic...
A Very Large Malignant Phyllodes Tumor with Skin Ulceration and Nipple Areola Complex Involvement—Still a Reality!!!
Cystosarcoma phyllodes is an uncommon neoplasm of the breast, constituting 0.3–0.9 % of all breast tumors. The incidence of malignant phyllodes tumor is even lower. The tumor is similar to fibroadenoma in...
Preparing Medico Legal Report in Clinical Practice
Doctors are frequently asked to prepare reports for a variety of medicolegal purposes including court proceedings, worker’s compensation, and insurance reports. The aim of this article is to provide doctors with...
Diagnostic Role of Platelet Lymphocyte Ratio(PLR) in Pancreatic Head Masses
Masses in and around pancreas constitute an important clinical entity in gastrointestinal surgical practice. Most common being adenocarcinoma of head of pancreas followed by inflammatory masses due to chronic pancreatiti...