부산대학교 도서관

Background. Myorenal or crush syndrome often develops following soft-tissue traumatic injury. It is a spectrum of disease that may result in severe renal dysfunction and kidney injury requiring renal replacement therapy. Objectives. To review a large cohort of patients with so-called myorenal or crush syndrome and assess the biochemical markers of venous bicarbonate and creatine kinase as predictors for the development of acute kidney injury (AKI). Methods. All patients with myorenal syndrome who presented to Khayelitsha District Hospital, Cape Town, South Africa (SA), and Ngwelezana Hospital, Empangeni, KwaZulu-Natal, SA, between January and December 2017 were identified and reviewed. Results. A total of 212 patients were included in the study. At both hospitals, 94% of the patients were male. Using the Pearson correlation coefficient, we compared creatinine kinase (CK) against serum creatinine. The mean CK level was 5 311.8 U/L and the mean creatinine level 133.457 [micro]mol/L. The r-value was 0.2533. Although this is a technically positive correlation, the relationship between the variables is weak. Using the Pearson R Calculator, we inserted the r-value to calculate the p-value. The p-value was 0.000208. When comparing venous bicarbonate (HC[O.sub.3]) against creatinine, the mean HC[O.sub.3] level was 22.296 mmol/L and the mean creatinine level 162.053 [micro]mol/L. The r-value was -0.3468. Although this is a technically negative correlation, the relationship between the variables is weak. Using the Pearson R Calculator, we inserted the r-value to calculate the p-value. The p-value was 0.000013. The inverse ratio shown with HC[O.sub.3] v. creatinine, although still a weak correlation, is significantly better in predicting an increase in creatinine compared with the weak positive correlation of CK v. creatinine. Conclusions. Although both venous HC[O.sub.3] and CK showed a weak correlation with creatinine, the former performed significantly better in predicting AKI. In a resource-constrained system, we recommend that HC[O.sub.3] be measured to assess patients with crush injury and that CK be regarded as a complementary modality. S Afr Med J 2021;111(4):333-337. https://doi.org/10.7196/SAMJ.2021.v111i4.14915
Myorenal syndrome following significant soft-tissue injury remains a common presentation in South Africa (SA). [1,2] The pathophysiology of massive soft-tissue disruption has been well described and involves myoglobin deposition in [...]