Abstract
Jpn J Artif Organs 25(6), 952-955 (1996) Acute renal failure is recognized as a complication of rhabdomyolysis. Currently attempts have been made to remove myoglobin using plasma exchange, but it's efficiency is unsatisfactory. The purpose of this paper is to evaluate the ability of removing myoglobin of continuous hemo-dialysis (CHD), which has been using as a renal replacement therapy recently. Eleven patients with rhabdomyolysis were involved in this study. They were all anuric and CHD was performed. Blood samples were obtained from pre- and postdialyser at 1, 6, 12, 24 h after the start of CHD and excreted fluids were sampled at the same time. The total amount of excreted fluids were recorded and a part of them were also sampled. Myoglobin concentrations were mesured using radioimmunoassay. Myoglobin concentrations were reduced in 6 of 11 patients and an average removed myoglobin during CHD was 75g per day. Myoglobin clearance was about 4.5 ml/min but it fell significantly at 6 h after induction. These results lead to the conclusion that it is not necessary to add plasma exchange for critically ill patients with rhabdomyolysis using the technique of CHD. It seems reasonable that dialyser has to be changed every day to get more efficient myoglobin removal because myoglobin clearance feel at 12 h after the start of CHD.
