Supreet Kaur
Department of Medicine, Division of Nephrology and Hypertension, The Mehandru Center for Innovation, Jersey Shore University Medical Center, Hackensack Meridian School of Medicine, Neptune, New Jersey, USA
Publications
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Case Report
Significance of Urine pH in Predicting Renal Outcomes for Patients with Rhabdomyolysis
Author(s): Sushil K. Mehandru*, Supreet Kaur, Avais Masud, Qalb Khan, Kyrillos Rezkalla, Prit Paul Singh, Suhas Patel, Tushar J. Vachharajani and Arif Asif
Acute kidney injury (AKI) is a common complication of rhabdomyolysis. Urine pH is important in predicting the occurrence of AKI. Acidic environment plays a major role in incidence of AKI. In this case report of 32 patients with rhabdomyolysis, majority of patients with urine pH<6.5 developed AKI whereas no renal dysfunction was found in patients with urine pH>7.0, regardless of levels of creatinine kinase. Low urine pH and intratubular acidosis facilitates higher concentration of myoglobin in the tubules as well as precipitation of myoglobin and uric acid casts that results in tubular obstruction and renal dysfunction. Myoglobin has direct nephrotoxic effect in aciduria. Acidification of body fluids and aciduria are independent risk factors for acute kidney injury (AKI) in patients in the presence of met-hemoglobinuria, well documented in patients before and after coronary arter.. Read More»