Korean Journal of Nephrology 1999;18(1):105-111.

알콜 중독과 관련된 횡문근 융해증에 의한 급성 신부전의 임상적 특성 (The Clinical Features of Acute Renal Failure Caused by Alcohol Induced Rhabdomyolysis)

신우승, 김영옥, 한충민, 홍순화, 임국희, 성용직, 윤선애, 김용수, 김석영, 방병기 (Woo Seung Shin, Young Ok Kim, Chung Min Han, Soon Hwa Hong, Kuk Hee Lim, Young Jik Sung, Sun Ae Yoon, Yong Soo Kim, Suk Young Kim and Byung Kee Bang)

Abstract

Alcohol can cause rhabdomyolysis by either direct toxicity or associated metabolic abnormality such as hypophosphatemia and hypokalemia. It can also predispose to or cause trauma, seizures, or coma- induced ischemic pressure necrosis. In order to investigate the clinical features of acute renal failure caused by alcohol induced rhabdomyolysis, we reviewed the medical records of the 12 patients. All patients had been drinking much amounts of alcohol for several years. All patients showed elevation of muscle enzyme such as creatine phosphokinase, lactic dehydrogenase, aspartate transaminase and blood urea nitrogen and serum creatinine. Predisposing factors of rhabdomyolysis were ischemic compression due to unconsciousness and dehydration(2 cases), and hypophosphatemia and dehydration(1 case), seizure and dehydration(1 case), and only severe dehydration(3 cases). Initial symptoms were painful swelling at lesion site(5 cases), abdominal pain(2 cases), general ache(2 cases), leg pain without swelling(1 case), dyspnea(1case), and lethargy(1 case). Seven patients developed delirium tremens during recovery stage. Eight patients showed oliguric acute renal failure and 8 patients were treated with hemodialysis. Complications were disseminated intravascular coagulation(DIC)(3 cases), compartment syndrome(2 cases), capillary leak syndrome and DIC(1 case). One of 12 patients died of disseminated intravascular coagulation and other patients showed complete recovery of renal function.