Acceso usuarios
Luis Marco Galindo, Antonio Blanco Morales, Julia Fernández Santafé, Darío Monesma Sorrosal, Laura Sanjuan Estallo, Juan Manuel Villar González
La rabdomiólisis es una patología que genera ruptura del tejido muscular, la cual libera mioglobina al torrente sanguíneo provocando daño en la función renal. Sus causas principales incluyen ejercicio intenso, deshidratación grave, consumo de drogas y afecciones musculares genéticas.
El diagnóstico se basa en la medición de creatina quinasa (CK), que suele ser mayor de cinco veces al valor de referencia. Los síntomas incluyen debilidad de la musculatura, fatiga, coloración cobriza de la orina y posible daño renal, además de tener complicaciones como arritmias cardíacas.
El tratamiento inicial comienza con fluidoterapia intravenosa a alta dosis y velocidad, para diluir los productos nefrotóxicos y mantener la permeabilidad renal. La identificación temprana de la patología y sus síntomas y la intervención precoz son indispensables para prevenir daños renales permanentes. En pacientes con un Score de McMahon mayor a 6, es necesario considerar terapia de reemplazo renal.
Un seguimiento y monitorización estrechos durante el tratamiento es indispensable para evitar complicaciones a causa de la rabdomiólisis.
Rhabdomyolysis is a condition characterized by the breakdown of muscle tissue, leading to the release of myoglobin into the bloodstream, which can cause renal damage. Its main causes include intense and prolonged exercise, severe dehydration, drug use such as cocaine or methamphetamines, and certain genetic musculoskeletal disorders. In young athletes, engaging in extreme physical activities such as marathons or intense anaerobic exercises is a common cause. Diagnosis is based on the measurement of creatine kinase (CK), which is usually at least five times higher than normal levels within the first 12-72 hours after the injury. Other useful indicators include myoglobin, LDH, potassium, and creatinine. Symptoms include fatigue, muscle weakness, dark urine color, and possible renal failure. Rhabdomyolysis can lead to serious complications such as acute renal failure and cardiac arrhythmias. Initial treatment should focus on intravenous fluid therapy to dilute toxic products and maintain renal perfusion. It is important to avoid the use of intravenous bicarbonate, as it can worsen the clinical picture, particularly in the presence of hypocalcemia. Early identification of the disease and appropriate intervention are crucial to preventing permanent renal damage. In patients with a high McMahon score, renal replacement therapy should be considered. Close monitoring during treatment is essential to ensure recovery and avoid long-term complications.
