respond to student discussion post, minimum of 250 words, APA 7th edition, 2 ref

respond to student discussion post, minimum of 250 words, APA 7th edition, 2 references
Rhabdomyolysis occurs when significant muscle breakdown happens from continuous contraction of muscle fibers causing inflammation and cell death (Gupta et al., 2021). Cell death results because of the increased stress on the cell, causing injury, (Gupta et al., 2021) that increases the release of myoglobin and serum enzymes such as creatine kinase (CK), potassium and phosphorus (Huether et al., 2020). Acute renal failure risk increases with the influx of these serum enzymes (Huether et al., 2020). Rhabdomyolysis can result from blunt trauma, burns, both medications and illicit drugs and various infectious agents such as bacteria and toxins (Huether et al., 2020). These situations can cause injury to muscle tissue and cells that has the potential to develop into rhabdomyolysis (Huether et al., 2020). Symptoms present in someone with rhabdomyolysis would be muscle pain, weakness, and dark urine (from myoglobin excreted in the urine) (Huether et al., 2020) which our case study patient reports experiencing muscle pain. His labs also resulted with 23,000 U/L CK which is about 135 times the amount of normal CK which is a strong sign of acute renal failure (indicated with any CK level above 15,000 U/Ls) and likelihood of rhabdomyolysis (Huether et al., 2020). Other testing to narrow down other possible diagnoses in this case would be testing for hyperkalemia, blood urea nitrogen to creatinine ratio and ultrasound of the affected area to assess muscle texture and subcutaneous tissues that are apparent in ultrasonographic images (Huether et al., 2020).
The causes of acute renal failure from rhabdomyolysis results from complications with myoglobin induced cytotoxicity and cellular damage/death which systemically causes vasoconstriction, hypovolemia and intraluminal cast formation (Gupta et al., 2021). Myoglobin causes oxidative stress on renal tubular cells which can lead to the release of oxidative free radicals, hypoxia, and ATP depletion (Gupta et al., 2021). This case study’s patient also has asthma and was exercising, putting a lot of stress on his muscles during his marathon, he significantly increased his risk of hypoxia and ATP depletion within cells. Additionally, the free radicals can cause ischemic damage while the myoglobin further induces tubular obstruction (Gupta et al., 2021). The obstruction then disrupts the flow of ultrafiltrate through the nephron producing kidney injury which is further injured by electrolyte imbalances from damaged/dead cells (Huether et al., 2020). These injuries lead to acute renal failure. Because of this, treatment for rhabdomyolysis includes maintaining appropriate urinary flow to prevent further damage and administration of IV fluids to rehydrate the patient and maintain kidney perfusion (Huether et al., 2020). Lastly, monitoring and treating abnormal electrolytes is also an important part of the treatment (Huether et al., 2020).
References
Gupta, A., Thorson, P., Penmatsa, K. R., & Gupta, P. (2021). Rhabdomyolysis: Revisited. The Ulster medical journal, 90(2), 61–69.
Huether, S. E., McCance, K. L., & Brashers, V. L. (2020). Understanding Pathophysiology 7th ed. Elsevier.