Biagio Barbano, Liborio Sardo, Maria L. Gasperini, Antonietta Gigante, Marta Liberatori, Gianluca G. Di Lazzaro, Francesca Di Mario, Barbara Dorelli, Antonio Amoroso and Rosario Cianci Pages 725 - 737 ( 13 )
Rhabdomyolysis is a syndrome due to a damage of skeletal muscle and the leakage of intracellular contents into the extracellular fluid and the circulation. Several causes may induce rhabdomyolysis and the major one is the crush syndrome. Most cases of non-traumatic rhabdomyolysis are related to drugs. Many molecules are subject to hepatic metabolism and the concomitant use of drugs, as statins, with other medications acting as substrates of the same isoenzymes can interact and increase the risk of myopathy.
Subclinical rise of creatine kinase may be the expression of rhabdomyolysis that can present as a medical emergency such as acute kidney injury (AKI), compartment syndrome, cardiac dysrhythmias and disseminated intravascular coagulopathy.
The main pathophysiological mechanisms of myoglobinuric-related AKI are renal vasoconstriction, formation of intraluminal casts and direct cytotoxicity promoted by heme-protein.
The aim of this review is to analyze the pathophysiology of myolysis, the causes of rhabdomyolysis and especially the link between the liver and the kidney, which can represent the connecting element for the development of the syndrome.
Rhabdomyolysis, acute kidney injury, liver disease, drugs metabolism, statins.
Department of Nephrology, “Sapienza”, University of Rome, Viale dell’Università 37, Rome, 00185, Italy.