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Rhabdomyolysis-induced acute kidney injury — RCPSC IM MCQ

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ModerateNephrologyRhabdomyolysis-induced acute kidney injuryRCPSC IM

A 39-year-old man is found after lying on the floor overnight following opioid overdose. He has thigh swelling and tea-coloured urine. Creatinine is 286 micromol/L, potassium is 5.8 mmol/L, phosphate is 2.1 mmol/L and creatine kinase is 74,000 U/L. Urinalysis is positive for blood with few red cells. What is the most likely cause?

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Correct answer: E — Myoglobin-mediated tubular injury

Rhabdomyolysis causes heme-pigment nephropathy from myoglobin, often with urine dipstick positive for blood but few red cells on microscopy.

Reference: KDIGO acute kidney injury guidance