Non-traumatic rhabdomyolysis: clinical and laboratory diagnosis, assessment of renal complications

PURPOSE: Non traumatic rhabdomyolysis (RML) is an infrequent and sometimes clinically silent syndrome. RML incidence is increasing in the last few years. A prospective study was performed: 1) to value the non traumatic RML incidence in patients admitted to Emergency Room; 2) to reevaluate the clinical and laboratory criteria of diagnosis; 3) to establish complications' incidence and prognosis during the recovery. PATIENTS AND METHODS: In Emergency Medical First Aid 15.301 patients were examined. To the study were admitted only patients having CK level grater than fivefold the upper normal limits and without trauma, recent surgery, heart and cerebral disease. RESULTS: During the six months study, non traumatic RML incidence was 0.1% (16 patients of 15.301). Drugs, alcohol and substance abuse acute intoxication were the commonest causes. The Acute Renal Failure (ARF) was the more frequent complication (9 patients of 16). Four patients of nine was treated only by fluid administration, the other five by dialysis. Oligoanuric-ARF appeared only in patients affected by toxic RML. These patients had no-return to normal renal functional values at the time of hospital discharge. CONCLUSIONS: Non traumatic RML should be take into account by emergency doctor in cases of acute intoxication. To prevent the complications it's necessary the right interpretation of clinical and laboratory datas and an early and adequate therapy.