THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURY
Crush syndrome (systemic manifestations of traumatic rhabdomyolysis) is the second leading cause of death after earthquakes or other destructive disasters. Crush-related acute kidney injury (AKI) is the most important component of crush syndrome, and medical professionals living in disaster-prone re...
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Istanbul University Press
2023-08-01
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| Series: | İstanbul Tıp Fakültesi Dergisi |
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| Online Access: | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/1BD7C9D0DD1140B3B570C66BF733ADA6 |
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| author | Özgür Akın Oto Mehmet Şükrü Sever |
| author_facet | Özgür Akın Oto Mehmet Şükrü Sever |
| author_sort | Özgür Akın Oto |
| collection | DOAJ |
| description | Crush syndrome (systemic manifestations of traumatic rhabdomyolysis) is the second leading cause of death after earthquakes or other destructive disasters. Crush-related acute kidney injury (AKI) is the most important component of crush syndrome, and medical professionals living in disaster-prone regions should know about its pathophysiology, clinical and laboratory features, complications, and treatment. Pathogenesis of AKI on the basis of crush injuries is multifaceted. The most important mechanism is compartment syndrome-related hypovolemia, and consequent renal hypoperfusion, which may result in ischemic acute tubular necrosis. Also, rhabdomyolysis-related myoglobinuria may result in the formation of kidney-damaging myoglobin casts and direct tubular toxicity. Formation of uric acid plugs, oxidant injury, increased serum levels of cytokines, and still many other factors may take a role in the pathogenesis as well. Crush syndrome can cause serious electrolyte imbalances, sepsis, and bleeding, which can further exacerbate AKI. Early recognition and appropriate management, which includes aggressive hydration and management of electrolyte imbalances can help to prevent or minimize kidney damage. This review provides an overview of the pathophysiology, complications, and treatment of AKI in the context of crush syndrome. |
| format | Article |
| id | doaj-art-b6982d57fa85421ca6b7693fd40191c8 |
| institution | DOAJ |
| issn | 1305-6441 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Istanbul University Press |
| record_format | Article |
| series | İstanbul Tıp Fakültesi Dergisi |
| spelling | doaj-art-b6982d57fa85421ca6b7693fd40191c82025-08-20T02:57:26ZengIstanbul University Pressİstanbul Tıp Fakültesi Dergisi1305-64412023-08-0186324525310.26650/IUITFD.1297993123456THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURYÖzgür Akın Oto0https://orcid.org/0000-0003-0928-8103Mehmet Şükrü Sever1https://orcid.org/0000-0002-6074-2239İstanbul Üniversitesi, İstanbul, Türkiyeİstanbul Üniversitesi, İstanbul, TürkiyeCrush syndrome (systemic manifestations of traumatic rhabdomyolysis) is the second leading cause of death after earthquakes or other destructive disasters. Crush-related acute kidney injury (AKI) is the most important component of crush syndrome, and medical professionals living in disaster-prone regions should know about its pathophysiology, clinical and laboratory features, complications, and treatment. Pathogenesis of AKI on the basis of crush injuries is multifaceted. The most important mechanism is compartment syndrome-related hypovolemia, and consequent renal hypoperfusion, which may result in ischemic acute tubular necrosis. Also, rhabdomyolysis-related myoglobinuria may result in the formation of kidney-damaging myoglobin casts and direct tubular toxicity. Formation of uric acid plugs, oxidant injury, increased serum levels of cytokines, and still many other factors may take a role in the pathogenesis as well. Crush syndrome can cause serious electrolyte imbalances, sepsis, and bleeding, which can further exacerbate AKI. Early recognition and appropriate management, which includes aggressive hydration and management of electrolyte imbalances can help to prevent or minimize kidney damage. This review provides an overview of the pathophysiology, complications, and treatment of AKI in the context of crush syndrome.https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/1BD7C9D0DD1140B3B570C66BF733ADA6crush syndromeacute kidney injuryrhabdomyolysis |
| spellingShingle | Özgür Akın Oto Mehmet Şükrü Sever THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURY İstanbul Tıp Fakültesi Dergisi crush syndrome acute kidney injury rhabdomyolysis |
| title | THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURY |
| title_full | THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURY |
| title_fullStr | THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURY |
| title_full_unstemmed | THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURY |
| title_short | THE KIDNEY AT RISK: UNDERSTANDING CRUSH SYNDROMERELATED ACUTE KIDNEY INJURY |
| title_sort | kidney at risk understanding crush syndromerelated acute kidney injury |
| topic | crush syndrome acute kidney injury rhabdomyolysis |
| url | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/1BD7C9D0DD1140B3B570C66BF733ADA6 |
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