Prevention and treatment of heme pigment-induced acute kidney injury
- Mark A Perazella, MD, FACP
Mark A Perazella, MD, FACP
- Professor of Medicine
- Yale University School of Medicine
- Mitchell H Rosner, MD
Mitchell H Rosner, MD
- Professor of Medicine
- University of Virginia Health System
Acute kidney injury (AKI) can occur in patients who have rhabdomyolysis and, less commonly, in patients with hemolysis [1,2]. In both groups of patients, AKI is caused by the nonprotein heme pigment that is released from either myoglobin or hemoglobin and is toxic to the kidney.
The prevention and treatment of heme pigment-induced AKI due to nontraumatic rhabdomyolysis or hemolysis will be reviewed here. The clinical features and diagnosis of this disorder, AKI due to traumatic muscle injury, overviews of rhabdomyolysis and hemolysis, and the general management of oliguric AKI and its complications are discussed elsewhere. (See "Clinical features and diagnosis of heme pigment-induced acute kidney injury" and "Crush-related acute kidney injury (acute renal failure)" and "Clinical manifestations and diagnosis of rhabdomyolysis" and "Diagnosis of hemolytic anemia in the adult" and "Dialysis-related factors that may influence recovery of renal function in acute kidney injury (acute renal failure)".)
In addition to treating the underlying rhabdomyolysis or hemolysis, the general goals for prevention of AKI in all patients at risk for heme pigment-induced AKI are twofold:
●Correction of volume depletion if present
●Prevention of intratubular cast formationTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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