Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: A case report and review of the literatures

被引：9
作者：
Sudarsanan S. [1 ]
Omar A.S. [1 ,2 ]
Pattath R.A. [1 ]
Al Mulla A. [1 ]
机构：
[1] Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU Section, Heart Hospital, Hamad Medical Corporation
[2] Department of Critical Care Medicine, Beni Suef
来源：
BMC Research Notes | / 7卷 / 1期
关键词：
Acute kidney injury; Coronary artery bypasses graft; Prolonged surgery; Rhabdomyolysis;
D O I：
10.1186/1756-0500-7-152
中图分类号：
学科分类号：
摘要：
Background: Post-operative rhabdomyolysis is a well-known complication, especially after bariatric and orthopaedic surgeries. There are few published reports of rhabdomyolysis following cardiac surgery. Acute kidney injury had been distinguished as a serious complication of cardiac surgery. We report a case of 55-years-old male patient who developed rhabdomyolysis precipitated acute kidney injury after coronary artery bypass graft. Case presentation. The patient underwent urgent coronary artery bypass graft surgery, with a long duration of surgery due to technical difficulty during grafting. He developed rhabdomyolysis induced acute kidney injury necessitating hemodialysis. The patient in turn developed heart failure, which along with acute kidney injury lead to prolonged ventilation. There was supervening sepsis with prolonged intensive care unity stay and eventually prolonged hospitalization. The peak creatine kinase level was 39000 IU/mL and peak myoglobin was 40000 ng/ml. Reviewing the patient, surgery was prolonged due to technical difficulties encountered during grafting, leading to rhabdomyolysis induced acute kidney injury. The pre-operative use of statins by the patient could also have contributed to the development of rhabdomyolysis. He developed post-operative right heart failure and sepsis. The patient's renal function gradually improved over 4 week's duration. Favorable outcome could be achieved but after prolonged course of renal replacement therapy in the form of hemodialysis. Conclusion: Prolonged duration of surgery is a well-recognized risk factor in the development of rhabdomyolysis. Early recognition of rhabdomyolysis induced acute kidney injury is important in reducing the post-operative morbidity and mortality in patients. A protocol based approach could be applied for early recognition and management. © 2014 Sudarsanan et al.; licensee BioMed Central Ltd.
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