Acute Kidney Injury Due to Rhabdomyolysis: A Review of Pathophysiology, Causes, and Cases Reported in the Literature, 2011–2021
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Keywords

Rhabdomyolysis
Acute kidney injury
Pathophysiology
Creatine kinase
Review

How to Cite

1.
da Silva Junior GB, Neves Pinto G, Campelo Fraga Y, De Francesco Daher E. Acute Kidney Injury Due to Rhabdomyolysis: A Review of Pathophysiology, Causes, and Cases Reported in the Literature, 2011–2021. Rev. Colomb. Nefrol. [Internet]. 2023 Dec. 30 [cited 2024 Dec. 11];10(3). Available from: https://revistanefrologia.org/index.php/rcn/article/view/619

Abstract

Introduction: Rhabdomyolysis (RML) is characterized by the destruction of muscle fibers and the release of intracellular constituents, with the potential to cause local and systemic complications, such as acute kidney injury (AKI).

Methodology: Literature review in which articles were analyzed between 2011 and 2021, from the PubMed database.

Results: RML can occur directly, indirectly, or secondary to trauma, metabolic disorders, medications and exogenous intoxication. Clinically, it may present asymptomatically, but a classic triad consisting of myalgia, generalized weakness and dark urine is common. AKI, despite being a late complication, is common. Laboratory markers used to diagnose RML are serum Creatine Kinase (CK) and serum and urinary Myoglobin, with CK being more sensitive. The approach can occur through classic strategies, such as hydration, diuretics, alkalinization and renal replacement therapy (RRT), but also through new strategies, such as iron chelators and antioxidants; anti-inflammatories and new extracorporeal blood filter.

Discussion: Trauma was the most common etiology of AKI due to RML, with a minority of patients requiring RRT. Furthermore, it was found that COVID-19 infection did not result in major kidney complications. Strenuous exercise has been shown to be a rare etiology of AKI due to RML. Other less common causes were drug use/intoxication and metabolic diseases, the majority of which patients did not require RRT or had a favorable outcome.

Conclusion: RML is a potentially serious condition, making it important to know its causes and management in order to reduce the chances of serious complications and to avoid patient death.

https://doi.org/10.22265/acnef.10.3.619
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References

Egoryan G, Chaudry S, Yadav K, Dong T, Ozcekirdek E, Ozen E, et al. Dark Urine as the Initial Manifestation of COVID-19: A Case Report. J Med Case Rep. 2021;15:576. https://doi.org/10.1186/s13256-021-03173-x

Samuel HU, Balasubramaniyan T, Thirumavalavan S, Vasudevan C, Senthil RP, Murugesan V, et al. Rhabdomyolysis with myoglobin-induced acute kidney injury: A case series of four cases. Indian J Pathol Microbiol. 2021;64:382–384.

Aleckovic-Halilovic M, Pjanic M, Mesic E, Storrar J, Woywodt A. From quail to earthquake and human conflict: a historical perspective of rhabdomyolysis. Clin Kidney J. 2020;14:1088–1096. https://doi.org/10.1093/ckj/sfaa075

Kwiatkowska M, Chomicka I, Malyszko J. Rhabdomyolysis - Induced Acute Kidney Injury - An Underestimated Problem. Wiad Lek. 2020;73:2543–2548. https://doi.org/10.36740/WLek202011137

Gupta A, Thorson P, Penmatsa K, Gupta P. Rhabdomyolysis: Revisited. Ulster Med J. 2021;90:61–69.

Butkus JM, Kramer M, Chan V, Kim E. Psychosis-Induced Exertional Rhabdomyolysis without Acute Kidney Injury or Myoglobinuria. Am J Case Rep. 2022;23:e934943. https://doi.org/10.12659/AJCR.934943

Lamzouri O, Bouchlarhem A, Haddar L, Elaidouni G, Es-Saad O, Bkiyar H, et al. SARS-CoV-2 infection presenting as rhabdomyolysis: case report and review. J Int Med Res. 2021;49:3000605211061035. https://doi.org/10.1177/03000605211061035

Taxbro K, Kahlow H, Wulcan H, Fornarve A. Rhabdomyolysis and Acute Kidney Injury in Severe COVID-19 Infection. BMJ Case Rep. 2020;13:e237616. https://doi.org/10.1136/bcr-2020-237616

Jahnke VS, Poloni JAT, Neves CAM, Peter C, Thompson CE, Rotta LN. Acute kidney injury associated with rhabdomyolysis in a patient with COVID-19. J Bras Nefrol. 2021 Mar 5;S0101-28002021005025301. https://doi.org/10.1590/2175-8239-JBN-2020-0170 Online ahead of print.

Cabral BMI, Edding SN, Portocarrero JP, Lerma EV. Rhabdomyolysis. Dis Mon. 2020;66:101015. https://doi.org/10.1016/j.disamonth.2020.101015

Mai H, Zhao Y, Salerno S, Li Y, Yang L, Fu P. Rhabdomyolysis-induced acute kidney injury in a patient with undifferentiated connective tissue disease: A case report and literature review rhabdomyolysis-induced AKI in a patient with UCTD. Medicine (Baltimore). 2019;98:e16492. https://doi.org/10.1097/MD.0000000000016492

Yang J, Zhou J, Wang X, Wang S, Tang Y, Yang L. Risk Factors for Severe Acute Kidney Injury among Patients with Rhabdomyolysis. BMC Nephrol. 2020;21:498. https://doi.org/10.1186/s12882-020-02104-0

Díaz-Tejeiro R, Regidor D, Morales J, Padrón M, Cueto L, Muñoz MA, et al. Acute renal failure due to rhabdomyolysis. Renal replacement therapy with intermediate cut-off membranes (EMIC2). Nefrologia (Engl Ed). 2018;38:664–665. https://doi.org/10.1016/j.nefroe.2018.04.009

Navarro-Blackaller G, Chávez-Iñiguez JS, Maggiani-Aguilera P, Gómez-Hernández GL, Carreón-Bautista EE, Moreno-Alvarado RA, et al. Rhabdomyolysis and acute kidney injury associated with Clostridium difficile infection, case report. Nefrologia (Engl Ed). 2019;39:208–209. https://doi.org/10.1016/j.nefroe.2018.07.009

Khu YL, Lewis B, Blackshaw L, Tan SMQ, Beyfield A, Schneider HG, et al. Aetiologies and factors associated with poor clinical outcomes in rhabdomyolysis: a retrospective cohort study in an Australian trauma centre. Intern Med J. 2021;51:264–267. https://doi.org/10.1111/imj.15183

Desgrouas M, Boulain T. Paracetamol use and lowered risk of acute kidney injury in patients with rhabdomyolysis. J Nephrol. 2021;34:1725–1735. https://doi.org/10.1007/s40620-020-00950-7

DeWolf MC, Norman MB, Molloy IB, Yong TM, Ramkumar DB, Veerareddy RR. Acute Tubular Necrosis from Rhabdomyolysis from Leg Compartment Syndrome: A Case Report. JBJS Case Connect. 2019;9:e0318. https://doi.org/10.2106/JBJS.CC.18.00318

Omrani H, Najafi I, Bahrami K, Najafi F, Safari S. Acute kidney injury following traumatic rhabdomyolysis in Kermanshah earthquake victims; a cross-sectional study. Am J Emerg Med. 2021;40:127–132. https://doi.org/10.1016/j.ajem.2020.01.043

Vangstad M, Bjornaas MA, Jacobsen D. Rhabdomyolysis: a 10-year retrospective study of patients treated in a medical department. Eur J Emerg Med. 2019;26:199–204. https://doi.org/10.1097/MEJ.0000000000000510

Chen CY, Lin YR, Zhao LL, Yang WC, Chang YJ, Wu HP. Clinical factors in predicting acute renal failure caused by rhabdomyolysis in the ED. Am J Emerg Med. 2013;31:1062–1066. https://doi.org/10.1016/j.ajem.2013.03.047

Chen CY, Lin YR, Zhao LL, Chieh W, Chang YJ, Wu KH, et al. Clinical spectrum of rhabdomyolysis presented to pediatric emergency department. BMC Pediatr. 2013;13:134. https://doi.org/10.1186/1471-2431-13-134

Chakravartty S, Sarma DR, Patel AG. Rhabdomyolysis in bariatric surgery: a systematic review. Obes Surg. 2013;23:1333–1340. https://doi.org/10.1007/s11695-013-0913-3

Bridi RA, Balbi AL, Neves PM, Ponce D. Acute kidney injury after massive attack of Africanised bees. BMJ Case Rep. 2014;2014:bcr2013201381. https://doi.org/10.1136/bcr-2013-201381

Papasotitiou M, Betsi G, Tsironi M, Assimakopoulos G. Rhabdomyolysis and acute kidney injury after acupuncture sessions. Saudi J Kindey Dis Transpl. 2014;25:643–646. https://doi.org/10.4103/1319-2442.132223

Lazarus SG, Wittkamp M, Messner S. Physical abuse leading to renal failure: a unique case of rhabdomyolysis. Clin Pediatr (Phila). 2014;53:701–703. https://doi.org/10.1177/0009922813492886

Tsai WH, Huang ST, Liu WC, Chen LW, Yang KC, Hsu KC, et al. High risk of rhabdomyolysis and acute kidney injury after traumatic limb compartment syndrome. Ann Plast Surg. 2015;74 Suppl 2:S158–S161. https://doi.org/10.1097/SAP.0000000000000460

Pollanen MS. Fatal rhabdomyolysis after torture by reverse hanging. Forensic Sci Med Pathol. 2016;12:170–173. https://doi.org/10.1007/s12024-016-9752-6

Krieger P, Zapolsky N, Lowery SJ. A case of severe rhabdomyolysis with minor trauma: Is sickle cell trait to blame? Am J Emerg Med. 2016;34:341.e3-4. https://doi.org/10.1016/j.ajem.2015.06.035

Omar AS, Ewila H, Aboulnaga S, Tuli AK, Singh R. Rhabdomyolysis following Cardiac Surgery: A Prospective, Descriptive, Single-Center Study. Biomed Res Int. 2016;2016:7497936. https://doi.org/10.1155/2016/7497936

Poloni JAT, Perazella MA. A Rarely Recognized Cause of Acute Kidney Injury in Rhabdomyolysis. Am J Med Sci. 2018;356:e27. https://doi.org/10.1016/j.amjms.2017.03.028

Das S, Hanuman SB, Mylapalli JL. Rhabdomyolysis associated acute renal failure - Report of two fatal cases and a brief review of literature. J Forensic Leg Med. 2020;71:101941. https://doi.org/10.1016/j.jflm.2020.101941

Wang D, Guo W, Tao XG, Zhang TT, Wang JQ. Platelet count as an independent risk factor for acute kidney injury induced by rhabdomyolysis. Chin Med J (Engl). 2021;134:1738–1740. https://doi.org/10.1097/CM9.0000000000001651

Magalhães SC, Lima LCR, Brito LC, Assumpção CO. Rabdomiólise induzida pelo exercício de força: revisão e análise dos principais relatos dos últimos 25 anos. R Bras Ci e Mov. 2018;26:189–199. https://doi.org/10.31501/rbcm.v26i1.7235

Rojas-Valverde D, Sánchez-Ureña B, Crowe J, Timón R, Olcina GJ. Exertional rhabdomyolysis and acute kidney injury in endurance sports: A systematic review. Eur J Sport Sci. 2021;21:261–274. https://doi.org/10.1080/17461391.2020.1746837

Shelmadine BD, Baltensperger A, Wilson RL, Bowden RG. Rhabdomyolysis and acute renal failure in a sickle cell trait athlete: a case study. Clin J Sport Med. 2013;23:235–237. https://doi.org/10.1097/JSM.0b013e3182625a37

Oh RC, Arter JL, Tiglao SM, Larson SL. Exertional rhabdomyolysis: a case series of 30 hospitalized patients. Mil Med. 2015;180:201–207. https://doi.org/10.7205/MILMED-D-14-00274

Esposito P, Estienne L, Sarpieri N, Ronchi D, Comi GP, Moggio M, et al. Rhabdomyolysis-Associated Acute Kidney Injury. Am J Kidney Dis. 2018;71:A12–A14. https://doi.org/10.1053/j.ajkd.2018.03.009

Abbas Mo, Brown V, Rietveld AP, Hoek AE. A marathon runner with rhabdomyolysis. Ned Tijdschr Geneeskd. 2019;163:D2848.

Wang C, Yu B, Chen R, Su L, Wu M, Liu Z. Association of D-dimer and acute kidney injury associated with rhabdomyolysis in patients with exertional heatstroke: an over 10-year intensive care survey. Ren Fail. 2021;43:1561–1568. https://doi.org/10.1080/0886022X.2021.2008975

Gualberto AJO, Freitas LCC, Teixeira MLS, Simonini ND, Silva PRA, Silva JFP. Rabdomiólise em adolescente com infecção por influenza tipo A: um relato de caso. Rev Educação em Saúde. 2020;8:197–202.

Sutarjono B, Alexis J, Sachidanandam JC. Legionella pneumonia complicated by rhabdomyolysis. BMJ Case Rep. 2019;12:e229243. https://doi.org/10.1136/bcr-2019-229243

Pérez J, Sánchez S, Sepúlveda RA, Vera M, Mery P, Garayar B, et al. Acute kidney injury caused by rhabdomyolysis as a SARS-CoV-2 infection manifestation. Report of one case. Rev Med Chil. 2021;149:641–647. https://doi.org/10.4067/s0034-98872021000300641

Hung PL, Lin PC, Tseng PL. Influenza-B associated rhabdomyolysis and acute renal failure. Indian Pediatr. 2013;50:595–596. https://doi.org/10.1007/s13312-013-0158-1

Rodríguez E, Soler MJ, Rap O, Barrios C, Orfila MA, Pascual J. Risk Factors for acute kidney injury in severe rhabdomyolysis. PLoS One. 2013;8:e82992. https://doi.org/10.1371/journal.pone.0082992

Siriyakorn N, Insiripong S. Fatal rhabdomyolysis in dengue hemorrhagic fever: a case report. Southeast Asian J Trop Med Public Health. 2015;46 Suppl 1:149–152.

Mishra A, Singh VK, Nanda S. Rhabdomyolysis and acute kidney injury in dengue fever. BMJ Case Rep. 2015;2015:bcr2014209074. https://doi.org/10.1136/bcr-2014-209074

Nelson TV, Blaceri S, Biederman JI. Rhabdomyolysis and acute renal failure with syphilitic myositis. Kidney Int. 2016;89:1169. https://doi.org/10.1016/j.kint.2015.09.004

Meng FY, Liu XR, Fu Q. Acute renal failure caused by rhabdomyolysis in children: a clinical analysis of 26 cases. Zhongguo Dang Dai Er Ke Za Zhi. 2017;19:193–197.

Padiyar S, Deokar A, Birajdar S, Walawalkar A, Doshi H. Cytosorb for Management of Acute Kidney Injury due to Rhabdomyolysis in a Child. Indian Pediatr. 2019;56:974–976. https://doi.org/10.1007/s13312-019-1661-9

Tram N, Chiodini B, Montesinos I, Vicinanza A, Beretta-Piccoli, Gubbelmans N, et al. Rhabdomyolysis and Acute Kidney Injury as Leading COVID-19 Presentation in an Adolescent. Pediatr Infect Dis J. 2020;39:e314–e315. https://doi.org/10.1097/INF.0000000000002853

Samies NL, Pinninti S, James SH. Rhabdomyolysis and Acute Renal Failure in an Adolescent With Coronavirus Disease 2019. J Pediatric Infect Dis Soc. 2020;9:507–509. https://doi.org/10.1093/jpids/piaa083

Chedid NR, Udit S, Solhjou Z, Patanwala MY, Sheridan AM, Barkoudah E. COVID-19 and Rhabdomyolysis. J Gen Intern Med. 2020;35:3087–3090. https://doi.org/10.1007/s11606-020-06039-y

Chong WH, Saha B. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Associated with Rhabdomyolysis and Acute Kidney Injury (AKI). Am J Med Sci. 2020;360:738–739. https://doi.org/10.1016/j.amjms.2020.07.032

Li L, Liu Z. Rhabdomyolysis with acute anuria renal failure caused by surgical injection-induced tetanus in an adult. Clin Med (Lond). 2021;21:e103–e105. https://doi.org/10.7861/clinmed.2020-0841

Lacerda DRNB, Argondizzi GT, Machado MV, Rodrigues KMD, Silva CBO, Nunes PVR, et al. Rhabdomyolysis And Delirium Tremens In An Alcoholic Patient: Case Report. Braz J Develop. 2021;7:59534–59546. https://doi.org/10.34117/bjdv7n6-374

Gosho M. Rhabdomyolysis risk from the use of two?drug combination of antidyslipidemic drugs with antihypertensive and antidiabetic medications: a signal detection analysis. Fundam Clin Pharmacol. 2019;33:339–346. https://doi.org/10.1111/fcp.12435

Santos VHLD, Cavalcante EGHM, Cândido RSG, Sousa Filho SMA, Faria TBC, Sousa MNA. Frequency of rhabdomyolysis in patients with dyslipidemia using statin and fibrate. Braz J Develop. 2021;7:75411–75425. https://doi.org/10.34117/bjdv7n7-629

Hafouda Y, Sharma A, Li V, Yesudian PD. Double trouble: ciclosporin-simvastatin coinduced rhabdomyolysis. BMJ Case Rep. 2019;12:e225971. https://doi.org/10.1136/bcr-2018-225971

Mitaritonno M, Lupo M, Greco I, Mazza A, Cervellin G. Severe rhabdomyolysis induced by co-administration of cocaine and heroin in a 45 years old man treated with rosuvastatin: a case report. Acta Biomed. 2021;92:e2021089.

Carrasco R, Salinas M, Rossel V. Rhabdomyolysis and acute renal failure after cocaine overdose: report of one case. Rev Med Chil. 2011;139:480–483. https://doi.org/10.4067/S0034-98872011000400010

Scarfia RV, Clementi A, Granata A. Rhabdomyolysis and acute kidney injury secondary to interaction between simvastatin and cyclosporine. Ren Fail. 2013;35:1056–1057. https://doi.org/10.3109/0886022X.2013.810540

Campana C, Griffin PL, Simon EL. Caffeine overdose resulting in severe rhabdomyolysis and acute renal failure. Am J Emerg Med. 2014;32:111.e3–4. https://doi.org/10.1016/j.ajem.2013.08.042

Bachoumas K, Fiancette M, Lascarrou JB, Lacherade JC, Leclair F, Reignier J. Fatal rhabdomyolysis following the co-prescription of fusidic acid and pravastatin. Med Mal Infect. 2015;45(10):417–419. https://doi.org/10.1016/j.medmal.2015.09.006

Jullian-Desayes I, Roselli A, Lamy C, Alberto-Gondouin MC, Janvier N, Venturi-Maestri G. Rhabdomyolysis with Acute Renal Failure and Deep Vein Thrombosis Induced by Antipsychotic Drugs: A Case Report. Pharmacopsychiatry. 2015;48:265–267. https://doi.org/10.1055/s-0035-1564088

Gangahar D. A case of rhabdomyolysis associated with severe opioid withdrawal. Am J Addict. 2015;24:400–402. https://doi.org/10.1111/ajad.12255

Wu CS, Tong SH, Ong CT, Sung SF. Serotonin Syndrome Induced by Combined Use of Mirtazapine and Olanzapine Complicated with Rhabdomyolysis, Acute Renal Failure, and Acute Pulmonary Edema-A Case Report. Acta Neurol Taiwan. 2015;24:117–121.

Dogan I, Eser B, Seker A. Rare Cause of Acute Kidney Injury Associated With Rhabdomyolysis: Quail Meat Consumption. Ther Apher Dial. 2016;20:690–691. https://doi.org/10.1111/1744-9987.12423

Peña-Porta JM, Martínez-Burillo A, Urbano-Gonzalo O, Alvarez-Lipe R. Acute kidney injury secondary to rhabdomyolysis in a nonagenarian patient taking statins. Lessons to be considered. Nefrologia. 2016;36:181–182. https://doi.org/10.1016/j.nefro.2015.08.009

Argamany JR, Reveles KR, Duhon B. Synthetic cannabinoid hyperemesis resulting in rhabdomyolysis and acute renal failure. Am J Emerg Med. 2016;34:765.e1–2. https://doi.org/10.1016/j.ajem.2015.08.051

Lam RPK, Yip WL, Tsui MSH, Ng SW, Ching CK, Mak TWL. Severe rhabdomyolysis and acute kidney injury associated with methoxphenidine. Clin Toxicol (Phila). 2016;54:464–465. https://doi.org/10.3109/15563650.2016.1157724

Pourmand A, Li A, Yiu A, Mazer-Amirshahi M, Shokoohi H. Survival after profound acidosis and rhabdomyolysis due to dietary supplement use. Am J Emerg Med. 2016;34:2259.e1–2259.e3. https://doi.org/10.1016/j.ajem.2016.05.052

Dalugama C, Pathirage M, Kularatne SAM. Delayed presentation of severe rhabdomyolysis leading to acute kidney injury following atorvastatin-gemfibrozil combination therapy: a case report. J Med Case Rep. 2018;12:143. https://doi.org/10.1186/s13256-018-1685-0

Kamal F, Snook L, Saikumar JH. Rhabdomyolysis-Associated Acute Kidney Injury With Normal Creatine Phosphokinase. Am J Med Sci. 2018;355:84–87. https://doi.org/10.1016/j.amjms.2017.04.014

Watanabe Y, Koutoku H, Nagata H, Oda Y, Kikuchi H, Kojima M. Rhabdomyolysis with Acute Kidney Injury Caused by Bilateral Iliopsoas Hematoma in a Patient with Atrial Fibrillation. Intern Med. 2019;58:2887–2890. https://doi.org/10.2169/internalmedicine.2749-19

Gnanapandithan K, Karthik N, Singh A. Rhabdomyolysis and Acute Kidney Injury Associated with Anabolic Steroid Use. Am J Med. 2019;132:e652–e653. https://doi.org/10.1016/j.amjmed.2019.02.052

Godinho R, Bugnon S, Gracin T, Tataw J. Severe rhabdomyolysis-induced acute kidney injury following concomitant use of Genvoya® (EVG/COBI/FTC/TAF) and simvastatin; a case report. BMC Nephrol. 2019;20:69. https://doi.org/10.1186/s12882-019-1257-6

Lima Filho JCC, Ogawa MY, Andrade THS, Gadelha SAC, Fernandes PFCBC, Queiroz AL, et al. Spectrum of acute kidney injury associated with cocaine use: report of three cases. BMC Nephrol. 2019;20:99. https://doi.org/10.1186/s12882-019-1279-0

Samuel HU, Balasubramaniyan T, Thirumavalavan S, Vasudevan C, Kumar RPS, Murugesan V, et al. Rhabdomyolysis with myoglobin-induced acute kidney injury: A case series of four cases. Indian J Pathol Microbiol. 2021;64:382–384.

Ould-Nana I, Cillis M, Gizzi M, Gillion V, Hantson P, Gérard L. Rhabdomyolysis and acute kidney injury induced by the association of rosuvastatin and abiraterone: A case report and review of the literature. J Oncol Pharm Pract. 2021;27:216–219. https://doi.org/10.1177/1078155220923001

Hamadeh M, Narrallah K, Ajami Z, Zeaiter R, Abbas L, Hamadeh S, et al. Clinical Presentation and Management of Severe Acute Renal Failure in McArdle Disease. Clinical Presentation and Management of Severe Acute Renal Failure in McArdle Disease. Clin Med Res. 2021;19:90–93. https://doi.org/10.3121/cmr.2021.1641

Ditch SM, Tosh AK. A college student with muscle cramps and weakness. Diagnosis: Bulimia nervosa, purging subtype, complicated by rhabdomyolysis and acute renal failure. Clin Pediatr (Phila). 2013;52:770–773. https://doi.org/10.1177/0009922813488657

Celik H, Celik O, Guldiken S, Inal V, Puyan FO, Tugrul A. Pheochromocytoma presenting with rhabdomyolysis and acute renal failure: a case report. Ren Fail. 2014;36:104–107. https://doi.org/10.3109/0886022X.2013.832856

Giri PP, Akhtar S, Laha S, Sinha R. Are we ignoring coexisting rhabdomyolysis as an important aggravating factor for acute kidney injury among childhood diabetic ketoacidosis? J Pediatr Endocrinol Metab. 2020;34:251–254. https://doi.org/10.1515/jpem-2020-0251

Chiniwalar A, Fernando ME, Sujit S, Prasad NDS, Valavan KT. Rhabdomyolysis Induced Acute Kidney Injury in Acute Myeloid Leukemia: An Unusual Association. Saudi J Kidney Dis Transpl. 2020;31:877–880. https://doi.org/10.4103/1319-2442.292326

Baeza-Trinidad R. Rhabdomyolysis: A syndrome to be considered. Med Clin (Barc). 2022;158:277–283. https://doi.org/10.1016/j.medcli.2021.09.025

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