Crush kidney
| Classification according to ICD-10 | |
|---|---|
| T79.5 | Traumatic anuria
Crush syndrome kidney failure after crushing |
| M62.8 | Other specified muscle diseases
(non-traumatic) |
| G72.0 | Drug-induced myopathy |
| ICD-10 online (WHO version 2019) | |
As a crush kidney or rarely, as myorenales syndrome is the medicine of acute renal failure as a result of the disintegration of larger muscle masses called.
The muscle breakdown can occur as a crush syndrome due to external influences as a result of an injury or crushing of large muscle parts, often in burn, earthquake and burial victims. It can also occur as rhabdomyolysis from an internal cause, e.g. B. as adverse drug effects , snake venom , malignant hyperthermia , carbon monoxide poisoning and after electrical accidents .
Renal insufficiency , complicating the crush kidney , has long been viewed as the result of "clogging" of the renal tubules by products of muscle breakdown, mainly myoglobin . Today it is assumed that the acute functional disorder of the tubules ( tubulopathy ) is caused by a complex shock process in which acidic metabolic products ( acidosis ), an oxygen deficiency in the kidney tissue, potassium released from the tissue and adrenergic compensation mechanisms as well as certain proteins play a part.
therapy
If the clinical situation does not improve, it makes sense to give additional fluids and to determine the concentration of electrolytes in the blood and, if necessary, to substitute them. Mannitol also helps mobilize the extracellular fluid in the blood, and alkalizing the blood ensures that the myoglobin dissolves better in the blood and thus later in the urine.
If there are early signs of complications, consideration should be given to providing kidney replacement procedures .
