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| 과량의 Furosemide에 의한 저칼륨혈증에서 발생한 횡문근융해증 및 급성 신부전 |
| 금수미 , 박진형 , 박용범 , 신재욱 , 최움직이원 , 김이근 , 손호상 , 장성국 , 이상채 , 배정동 , 안기성 |
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| Abstract |
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Though hypokalemia often goes unrecognized as a cause of rhabdomyolysis, its causal relation for acute renal failure can be considered in cases of extreme hypokalemia when combined with rhabdomyolysis. We present the case of a 21-year-old female in whom acute renal failure was developed by myoglobinuria which was associated with furosemide ind- uced hypokalemia. She had taken 2 grams of furosemide daily over 6 months before developing rhab- domyolysis. Initial neurologic examination revealed painful quadriplegia and laboratory findings showed markedly elevated blood CPK, LDH and AST levels with azotemia. Arterial blood gas analysis showed pH 7.439, serum Na 128mEq/L, K 1.5mEq/L, Cl 87mEq/L, HC% 12.6mmol/L and calculated anion gap of 29.9 which indicated that she was under the condition of mixed metabolic alkalosis and metabolic acidosis. Though intravenous infusion of potassium chloride improved muscle strength, azotemia and acidemia persisted for several days. This case suggest that large amount of furose- mide, when used for a long time, can be result in the acute renal failure by rhabdomyolysis which was caused by hypokalemia. |
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