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KMID : 0359919880070010174
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Korean Journal of Nephrology
1988 Volume.7 No. 1 p.174 ~ p.181
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Effects of Dialysis TheraBy in 3 Cases of Acute Renal Failure Associated with Compartment Syndrome
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홍관수/Hong, Kwan Su
이일중/김동욱/김영균/홍영석/방병기/Lee, Ill Jung/Kim, Dong Wook/Kim, Young Kyoon/Yoon, Young Suk/Bang, Byung Kee
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Abstract
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We studied the characteristic clinical findings and the effect of dialysis therapy in 3 cases of hypercatabolic acute renal failure associated with muscle compartment syndrome which was induced by overnight muscle compression after drug abuse (phenobarbital, case 1) and carbon monoxide intoxication (case 23).
The major symptoms of muscle compartment syndrome in this cases were generalized muscle swelling with extreme tenderness, hypoesthesia, paralysis and aching pain with pallor and coldness in involved limb. Acute renal failrue was characterized by almost anuric hypercatabolic state, red brownish urine without RBC (myoglobinuria) and rapid increase of blood urea nitrogen. They were treated with immediate dialysis therapy including CAPD, intensive hemodialysis and combined dialysis. Renal functions were all returned to normal eventually, but uremic symptoms and the increse rate of blood urea nitrogen was less severe in intensive hemodialysis cases as compared with CAPD cases (Fig. 1,2,3). Fasciotomy was performed in case 2,3 because of severe muscle compartment syndrome with absent arterial pulsation, but permanent functional defect was remained in case 2 because of delayed fasciotomy.
It is concluded that ealry fasciotomy allowed preservation of function of involved limb in muscle compartment syndrome especially in cases of carbon monoxide intoxication, and intensive hemodialysis was more useful treatment in hypercatabolic acute renal failure than CAPD.
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