Acute Renal Failure in Rhabdomyolysis Associated with Furosemide Induced Hypokalemia.
- Author:
Soo Mi KEUM
1
;
Jin Hyung PARK
;
Yong Beom PARK
;
Jae Uk SHIN
;
Jong Won CHOI
;
Ih Geun KIM
;
Ho Sang SHON
;
Sung Gug CHANG
;
Sang Chae LEE
;
Jung Dong BAE
;
Ki Sung AHN
Author Information
1. Department of Internal Medicine, College of Medicine, Catholic University of Taegu-Hyosung, Taegu, Korea.
- Publication Type:Case Report
- Keywords:
Furosemide;
Hypokalemia;
Rhabdomyolysis;
Acute renal failure
- MeSH:
Acid-Base Equilibrium;
Acidosis;
Acute Kidney Injury*;
Alkalosis;
Azotemia;
Blood Gas Analysis;
Female;
Furosemide*;
Humans;
Hydrogen-Ion Concentration;
Hypokalemia*;
Infusions, Intravenous;
Muscle Strength;
Myoglobinuria;
Neurologic Examination;
Potassium Chloride;
Quadriplegia;
Rhabdomyolysis*;
Young Adult
- From:Korean Journal of Nephrology
1997;16(2):385-390
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Though hypokalemia often goes unrecognized as a cause of rhabdomyolysis, its causal relation for acute renal failure can be considered in cases of extreme hypokalemia when combined with rhabdomyolysis. We present the case of a 21-year-old female in whom acute renal failure was developed by myoglobinuria which was associated with furosemide induced hypokalemia. She had taken 2 grams of furosemide daily over 6 months before developing rhabdomyolysis. Initial neurologic examination revealed painful quadriplegia and laboratory findings showed markedly elevated blood CPK, LDH and AST levels with azotemia. Arterial blood gas analysis showed pH 7.439, serum Na 128mEq/L, K 1.5mEq/L, Cl 87mEq/L, HCO3- 12.6mmol/L and calculated anion gap of 29.9 which indicated that she was under the condition of mixed metabolic alkalosis and metabolic acidosis. Though intravenous infusion of potassium chloride improved muscle strength, azotemia and acidemia persisted for several days. This case suggest that large amount of furosemide, when used for a long time, can be result in the acute renal failure by rhabdomyolysis which was caused by hypokalemia.
