Acute kidney injury after coronary artery bypass grafting: does rhabdomyolysis play a role?
An increase in laboratory findings of muscle injury postoperatively, especially serum myoglobin concentration, predicts the incidence of acute kidney injury and renal replacement therapy requirement, as reported in other surgical settings. Perioperative myocardial injury cannot totally explain the occurrence of increased myoglobinemia. These results suggest an important role of skeletal muscle breakdown and necrosis in determining an increased myoglobinemia concentration after coronary artery bypass grafting.
Since neutrophils have been shown to secrete HOCl/OCl(-) up to 100 micromol/L, inactivation of plasmin molecules by neutrophil-generated HOCl/OCl(-) could partly explain the increased thrombo-genicity observed in inflammatory conditions, in smokers and in other diseases. Thus, dietary intervention or the use of thiols or large doses of taurine compounds may be useful as coadjuvant therapeutic measures.