ELECTRIC SHOCK AND ACUTE KIDNEY INJURY WITH REFRACTORY HYPERKALEMIA AND METABOLIC ACIDOSIS: CASE REPORT IN SARDJITO HOSPITAL YOGYAKARTA

B PURWANTO1, I KUSWADI2, H PRASANTO3
1Sardjito Hospital Yogyakarta, Yogyakarta, Indonesia, 2Sardjito Hospital Yogyakarta, Yogyakarta, Indonesia, 3Sardjito Hospital Yogyakarta, Yogyakarta, Indonesia 

Background: The first detailed cases of crush syndrome were described in 1941 in London after victims trapped beneath bombed buildings presented with swollen limbs, hypovolemic shock, dark urine, renal failure, and ultimately perished. Crush trauma to the extremities, even if not involving vital organs, can be life threatening. Crush syndrome, the systemic manifestation of the breakdown of muscle cells with release of contents into the circulation, leads to metabolic derangement and acute kidney injury. In burn unit, patients after electric shock and fasciotomy need attention because it can happen crush syndrome.
Case Report:  A 60-year-old man with burns caused by electric shock, performed wound care and fasciotomy during treatment at the burn unit. There is no history of Diabetes Mellitus, Hypertension and kidney disease. On the 45th day, patients began to appear anuria, acute kidney injury, refractory hyperkalemia and metabolic acidosis.
Conclusion: This case is crush syndrome, resuscitation with i.v. fluids is the mainstay of treatment and can help guide critical steps in management fluid resuscitation. This basic intervention has been shown to in large part prevent progression of acute kidney injury to requiring haemodialysis.  Providers must be aware of the risk of hyperkalemia
Keywords: Electric Shock; Acute Kidney Injury, Hyperkalemia; Acidosis Metabolic


Biography:
Fellow on  Renal and Hypertension Division, Internal Medicine Departement, Sardjito Hospital Yogyakarta Indonesia

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