The Use of Supra-Hemodiafiltration in Traumatic Rhabdomyolysis and Acute Kidney Injury: A Case Report

Abstract

Oliguric acute kidney injury due to traumatic rhabdomyolysis can be potentially lethal if the proper medical therapy combined with extracorporeal detoxification is not performed. Different extracorporeal techniques are available to overcome this syndrome. Here, we report the first case of removal of myoglobin and successful recovery from acute kidney injury in an elderly septic patient using supra-hemodiafiltration with endogenous reinfusion technique (HFR-Supra) combined with the medical therapy.

Keywords: Acute kidney injury; Extracorporeal detoxification; HFR-Supra technique; Hemodiafiltration; Myoglobin; Rhabdomyolysis.

Fig. 1

Ecchymosis of the legs at hospital admission.

Fig. 2

HFR-Supra: schematic diagram. Qb, blood flow; Q plw, plasmatic water flow; kDa, kilodaltons; SC, sieving coefficient.

Fig. 3

Trends in the reduction of circulating levels of myoglobin (a), CPK (b), LDH (c), CRP (d), and PTC (e) over the 5 days of HFR-Supra treatment. The black line with diamonds represents the analyte levels before the dialysis session and the grey line with squares the ones after the dialysis session. CPK, creatine phosphokinase; CRP, C-reactive protein; LDH, lactate dehydrogenase; PCT, procalcitonin.

Fig. 4

Sorbent cartridge of HFR-Supra during the detoxification process.