Palacios-Pérez E, Cerda-Téllez F, Suárez-Cuenca J, Elizalde CI, García-Sánchez JL, Hernández-Sánchez M, Vergara-Orduña F

Idioma: Español
Referencias bibliográficas: 40
Paginas: 191-197
Archivo PDF: 234.54 Kb.

RESUMEN

Objetivo: Comparar la capacidad predictiva de mioglobina, creatincinasa total y hemoglobina en orina de lesión renal aguda en pacientes con traumatismo.
Material y Método: Estudio transversal, analítico, comparativo, observacional, en el que se identificaron todos los pacientes mayores de 18 años con diagnóstico de traumatismo o politraumatismo, provenientes del servicio de urgencias, de agosto de 2017 a enero de 2018 en el Hospital General Xoco de la Secretaría de Salud de la Ciudad de México, se midieron: mioglobina, creatincinasa total, concentraciones de creatinina y hemoglobina en orina a su ingreso.
Resultados: Se incluyeron 24 pacientes de 20 a 79 años de edad, con predominio del género masculino. Al comparar las áreas bajo la curva de las pruebas se determinó que no hubo significación estadística (p = 0.266) para la creatincinasa de ingreso porque mostró un área bajo la curva de 0.636, el intervalo de confianza al 95% se encontró por debajo de 0.500. Asimismo, la mioglobina de ingreso se observó en un área bajo la curva de 0.657 (p = 0.198; IC 95% 0.423-0.891).
Conclusiónes: Las concentraciones de creatincinasa total y mioglobina no demostraron ser predictores adecuados de lesión renal al no haber diferencia significativa; sin embargo, se encontró que las concentraciones de creatinina al ingreso tienen mayor capacidad predictiva de lesión renal aguda en pacientes con traumatismo e hiperCKemia.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Bosch X, Poch E, Grau J. Rhabdomyolysis and acute kidney injury. N Engl J Med 2009;361:62-72.

2. Madrazo M, Uña R, Redondo F, Criado A. Rabdomiólisis isquémica y fracaso renal agudo. Rev Esp Anestesiol Reanim 2007;54:425-435.

3. Chavez, et al. Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice Critical Care 2016.

4. Boutaud O, Roberts II. Mechanism-based therapeutic approaches to rhabdomyolysis-induced renal failure. Free Radical Biology & Medicine 2011;51:1062-1067.

5. Zimmerman J, Shen M. Rhabdomyolysis. Chest 2013;144:1058-1065.

6. Zutt R, et al. Rhabdomyolysis: Review of the literature. Neuromuscular Disorders 2014;24:651-659.

7. Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis: an evaluation of 475 hospitalized patients. Medicine 2005;84:377-385.

8. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int 2012; 2(suppl):1-138.

9. Baeza-Trinidad R, Brea-Hernando A, Morera-Rodriguez S, Brito-Diaz Y, Sanchez-Hernandez S, El Bikri L, et al. Creatinine as predictor value of mortality and acute kidney injury in rhabdomyolysis. Intern Med J 2015;45(11):1173-8.

10. Lappalainen H. Elimination kinetics of myoglobin and creatine kinase in rhabdomyolysis: implications for follow-up. Crit Care Med 2002;30(10):2212-5.

11. Talaie H, Emam-Hadi M, Panahandeh R, Hassanian- Moghaddam H, Abdollahi M. On the mechanisms underlying poisoning-induced rhabdomyolysis and acute renal failure. Toxicol Mech Methods 2008;18:585-8.

12. Iraj N, Saeed S, Mostafa H, Houshang S, Ali S, Farin RF, et al. Prophylactic fluid therapy in crushed victims of Bam earthquake. Am J Emerg Med 2011;29:738-42.

13. Watanabe T. Rhabdomyolysis and acute renal failure in children. Pediatr Nephrol 2001;16:1072-5.

14. Lima RS, da Silva GB, Liborio AB, Daher Ede F. Acute kidney injury due to rhabdomyolysis. Saudi J Kidney Dis Transpl 2008 Sep;19(5):721-9.

15. Díaz M, Nava A, Meneses J, Moreno A, González J, Briones J. Insuficiencia renal aguda en trauma. Rev Asoc Mex Med Crit y Ter Int 2008;22(1):36-41.

16. Polderman KH. Acute renal failure and rhabdomyolysis. Int J Artif Or gans 2004 Dec;27(12):1030-3.

17. Mote J, Díaz S, Lee Eng C. Rabdomiólisis y lesión renal aguda. Med Int Mex 2007;23:47-58.

18. Sudarsanan S, Omar AS, Pattath RA, Al Mulla A. Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: a case report and review of the literatures. BMC Res Notes. 2014 17;7:152. doi: 10.1186/1756-0500-7-152

19. Rodríguez-Capote K, Balion CM, Hill SA, Cleve R, Yang L, El Sharif A. Utility of urine myoglobin for the prediction of acute renal failure in patients with suspected rhabdomyolysis: a systematic review. Clin Chem 2009;55(12):2190-2197. doi: 10.1373/clinchem.2009.128546

20. Shapiro ML, Baldea A, Luchette FA. Rhabdomyolysis in the intensive care unit. J Intensive Care Med 2012;27(6):335- 342. doi: 10.1177/0885066611402150.

21. El-Abdellati E, Eyselbergs M, Sirimsi H, Van Hoof V, Wouters K, Verbrugghe W, Jorens PG. An observational study on rhabdomyolysis in the intensive care unit. Exploring its risk factors and main complication: acute kidney injury. Ann Intensive Care 2013;3(1):1-8. doi: 10.1186/2110-5820-3-1.

22. L.S. Sharp et al. Rhabdomyolysis and secondary renal failure in critically ill surgical patients. Am J Surg 2004;188.

23. O’Connor FG, Deuster PA. Rhabdomyolysis. In: Goldman L, Ausiello D, editors. Cecil Medicine. Oxford: Elsevier- Saunders, 23rd ed., 2007.

24. Mrsić V, Nesek Adam V, Grizelj Stojcić E, Rasić Z, Smiljanić A, Turcić. Acute rhabdomyolysis: a case report and literature review Acta Med Croatica 2008 Jul;62(3): 317-22.

25. Daher Ede F, Silva Júnior GB, Brunetta DM, Pontes LB, Bezerra GP. Rhabdomyolysis and acute renal failure after strenuous exercise and alcohol abuse: case report and literature review. Sao Paulo Med J 2005 Jan 2;123(1):33-7. Epub 2005 Mar 31.

26. Sulowicz W, Walatek B, Sydor A, et al. Acute renal failure in patients with rhabdomyolysis. Med Sci Monit 2002;8(1):CR24-7.

27. Lane R, Phillips M. Rhabdomyolysis. BMJ 2003;327(7407):115-6.

28. Nieto-Ríos JF, Vega-Miranda J, Serna-Higuita LM. Insuficiencia renal aguda inducida por rabdomilisis. Iatreia. 2016 Abr- Jun;29(2):157-169. DOI 10.17533/udea. iatreia.v29n2a05.

29. de Meijer AR, Fikkers BG, de Keijzer MH, van Engelen BG, Drenth JP. Serum creatine kinase as predictor of clinical course in rhabdomyolysis: a 5-year intensive care survey. Intensive Care Med 2003;29(7):1121-1125.

30. Waikar SS, Wald R, Chertow GM, et al. Validity of International Classification of Diseases, Ninth Revision, Clinical Modification codes for acute renal failure. J Am Soc Nephrol 2006;17(6):1688-1694.

31. Rhee CM, Bhan I, Alexander EK, Brunelli SM. Association between iodinated contrast media exposure and incident hyperthyroidism and hypothyroidism. Arch Intern Med 2012;172(2):153-159.

32. Ward MM. Factors predictive of acute renal failure in rhabdomyolysis. Arch Intern Med 1988;148(7):1553-1557.

33. Gabow PA, Kaehny WD, Kelleher SP. The spectrum of rhabdomyolysis. Medicine (Baltimor e) 1982; 61(3):141-152.

34. Hoffman MD, Ingwerson JL, Rogers IR, Hew-Butler T, Stuempfle KJ. Increasing creatine kinase concentrations at the 161-km Western States Endurance Run. Wilderness Environ Med 2012;23(1):56-60.

35. Clarkson PM, Kearns AK, Rouzier P, Rubin R, Thompson PD. Serum creatine kinase levels and renal function measures in exertional muscle damage. Med Sci Sports Exerc 2006;38(4):623-627.

36. Heled Y, Bloom MS, Wu TJ, Stephens Q, Deuster PA. CKMM and ACE genotypes and physiological prediction of the creatine kinase response to exercise. J Appl Physiol 2007;103(2):504-510.

37. Woodrow G, Brownjohn AM, Turney JH. The clinical and biochemical features of acute renal failure due to rhabdomyolysis. Ren Fail 1995;17(4):467-474.

38. Laios ID, Caruk R, Wu AH. Myoglobin clearance as an early indicator for rhabdomyolysis-induced acute renal failure. Ann Clin Lab Sci 1995;25(2):179-84.

39. Brancaccio P, Lippi G, Maffulli N. Biochemical markers of muscular damage. Clin Chem Lab Med 2010;48(6):757- 767.

40. Abassi ZA, Hoffman A, Better OS. Acute renal failure complicating muscle crush injury. Semin Nephrol. 1998 Sep;18(5):558-65.