Crush syndrome

Crush syndrome kidney failure after crushing

( non- traumatic)

As crush kidney or less commonly as myorenales syndrome acute renal failure as a result of decay is described by larger muscle mass in medicine.

The muscle decay can be used as crush syndrome caused by external influences as a result of an injury or bruise large parts of the muscle, often in combustion, earthquake and Verschüttungsopfern. It can also occur as rhabdomyolysis from inner cause, eg as an adverse reaction by snake venom in malignant hyperthermia, carbon monoxide poisoning and after electrical accidents.

The confounding in the crush - kidney renal insufficiency has long been seen as a result of a " blockage " of the renal tubules by products of muscle decay, mainly by myoglobin. Today, it is estimated that acute dysfunction of the tubules ( tubular dysfunction ) caused by a complex shock process in which acidic metabolic products (acidosis ), a lack of oxygen in the kidney tissue, liberated from the tissue potassium and adrenergic compensatory mechanisms, as well as certain proteins have a share.

Therapy

The clinical situation does not improve, so it makes sense to give liquid to determine electrolytes in the blood and to substitute if necessary. Furthermore, mannitol helps to mobilize the extracellular fluid into the blood, and the alkalization of the blood ensures that the myoglobin thus better later dissolves in the blood and urine. Even with early signs of complications, the possibility should be considered to provide renal replacement therapy.

• Disease in intensive care