Korean J Med.  1997 May;52(5):716-721.

A Case with Diabetic Hyperosmolar Nonketotic Coma Who Developed Acute Renal Failure Secondary to Rhabdomyolysis

• Park JK
• Kim GS
• Suh SY
• Ko HS
• Jo JS

Abstract

Rhabdomyolysis is defined as skeletal muscle injury with release of muscle cell constituents into the plasma and may lead to acute renal failure secondary to myoglobinuria. The most sensitive marker of muscle cell damage is serum creatine kinase concentration. It was first described by Bywaters and Beall in association with crush injuries during the second world war, and since then it has been recognized as the cause of about 5 % of all cases of acute renal failure. But acute renal failure is extremely rare in diabetic patient with hyperosmolarity irrespective of the frequency of rhabdomyolysis. Since osmotic diuresis, which is provoked by a high renal glucose load, prevents the development of acute tubular necrosis; there have been a few case reports connecting diabetic hyperosmolar state with acute renal failure, secondary to rhabdomyolysis. We reported a case with diabetic hyperosmolar nonketotic coma who developed acute renal failure secondary to rhabdomyolysis and myoglobinuria in a 60 year old patient with review of the literatures.

Keyword

Rhabdomyolysis; Acute renal failure

MeSH Terms

Acute Kidney Injury*
Coma*
Creatine Kinase
Diuresis
Glucose
Humans
Middle Aged
Muscle Cells
Muscle, Skeletal
Myoglobinuria
Necrosis
Plasma
Rhabdomyolysis*
World War II
Creatine Kinase
Glucose