Korean Journal of Nephrology 1991;10(1):25-31.

외상환자의 뇨소견에 관한 연구

김홍주 , 윤성철 , 유문집 , 정필현

Abstract

RhaMomyolysis with extensive trauma is the con- spicuous cause of acute renal failure because potassium, phosphate, amino acid and myoglobin, creatinine are released from muscle necrosis. Another cause of rhabdomyolysis can also be associat- ed with infectious diseases, drug overdose, severe exer- cise, seizure, congenital muscle disease, primary aldos- teronism and so on. The purpose of this study was to determine the clini- cal importance of reversible renal injury which was caused by various kinds of rhabdomyolysis, because many cases were clinically inapparent without the evi- dence of renal involvement. The subjects of the study were the patients with fracture trauma who were admitted to the Orthopedic Department from June, 1989 to July, 1990. These patients were divided into three groups: minor fracture such as finger or toe fracture, without edema (Group 1), fracture with moderate edema (Group 2), fracture with marked edema (Group 3), and were anal- yzed mainly with the use of urine findings. The results were as followa 1) A quarter of studied patients (N=67) showed ab- normal urine findings (I.e. pyuria, hematuria, orpand proteinuria (total studied No=266). 2) The more the patient was severely traumatized aad the more the patient had a acidified urine pH, then the abnormality of the urine was detected more fre- quently and more severely. 3) In 10 severely injured patients with manifest renal symptom, urine output was increased despites of reduced GFR but FeNa was fluctuated. In conclusion, 25% of traumatized patients showed abnormal UA findings and most of these cases were not accompanied with clinical manifestation involving the kidney. This means that the occurrence of many inapparent nephropathy induced by rhabdomyolysis may be more prevalent than the expected, and most of them are thought to be reversible.