Abstract
Serum CK levels that represent the severity of rhabdomyolysis are considered to be correlated with the development of acute renal failure. Here we report 2 cases of extreme rhabdomyolysis caused by hyponatremia and ethanol intoxication, in which peak serum CK levels were 541,300 and 621,912 IU·l−1, respectively. They were resuscitated with crystalloid solution under strict monitoring of urine volume and renal function, and did not develop acute renal failure during the course. No other specific treatments were required. Acute physiology and chronic health evaluation (APACHE) II scores in these 2 cases were 11 and 2 points, respectively, and both patients met the criteria of systemic inflammatory response syndrome (SIRS) only on the first day of admission. It is suggested that the development of acute renal failure in rhabdomyolysis mainly depends on the initial severity of the disease as indicated by APACHE II score or persistent systemic inflammation as indicated by the duration of SIRS rather than the severity of muscle destruction.
