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Abstract(s)
A incidência de rabdomiólise em indivíduos saudáveis tem vindo a aumentar, o
que pode ser o resultado da popularidade crescente dos treinos de resistência de alta
intensidade, nomeadamente de atividades como o Crossfit ou o Spinning. É, no
entanto, difícil de avaliar, uma vez que não apresenta critérios laboratoriais e/ou
clínicos universalmente aceites para o diagnóstico.
A rabdomiólise induzida pelo exercício é, geralmente, definida como uma
síndrome clínico-laboratorial que resulta da lise das células musculares esqueléticas,
com a libertação de substâncias intracelulares para a circulação. Os pacientes
apresentam uma combinação de sintomas musculares (mialgias, fraqueza e edema), em
conjugação com um aumento substancial da creatina-quinase sérica, após a realização
de atividade física. A rabdomiólise pode também ocorrer devido a traumatismo, crises
convulsivas, consumo de álcool ou drogas, entre outras causas. Quando recorrente,
importa também considerar a existência de doenças metabólicas hereditárias, que
aumentam o risco de rabdomiólise.
O tratamento consiste, essencialmente, em instituir fluidoterapia – oral ou
intravenosa, consoante a gravidade da doença -, podendo-se considerar ainda o uso de
bicarbonato de sódio, com o objetivo de prevenir a precipitação de mioglobina nos
túbulos renais.
Esta síndrome apresenta um bom prognóstico, dado que a maioria dos
pacientes recuperam sem quaisquer complicações. No entanto, as suas principais
complicações são lesão renal aguda, síndrome comportamental e coagulação
intravascular disseminada.
Assim sendo, esta dissertação visa fazer uma revisão da literatura existente
acerca da rabdomiólise induzida pelo exercício, com um enfoque maior nas
complicações renais resultantes.
The incidence of rhabdomyolysis in healthy individuals has been increasing, which may be the result of the increasing popularity of high intensity resistance training, such as Crossfit or Spinning. However, it is difficult to assess, since it does not have universally accepted laboratory and/or clinical criteria for diagnosis. Exercise-induced rhabdomyolysis is generally defined as a clinical-laboratory syndrome that results from the lysis of skeletal muscle cells, with the release of intracelular substances into circulation. Patients have a combination of muscle associated symptoms (myalgia, weakness and edema), in conjuction with a substantial increase in serum creatine kinase, after physical activity. Rhabdomyolysis can also occur due to trauma, seizures, consumption of alcohol or drugs, among other causes. When recurring, it is also important to consider the existence of inherited metabolic diseases, which increases the risk of rhabdomyolysis. The treatment essentially consists of instituting fluid therapy – oral or intravenous, depending on the severity of the disease -, and the use of sodium bicarbonate can also be considered, in order to prevent myoglobin precipitation in the renal tubules. This syndrome has a good prognosis, since must patients recover without any complications. However, its main complications are acute kidney injury, compartimental syndrome and disseminated intravascular coagulation. Therefore, this dissertation aims to review the existing literature on exerciseinduced rhabdomyolysis, with a greater focus on the resulting renal complications.
The incidence of rhabdomyolysis in healthy individuals has been increasing, which may be the result of the increasing popularity of high intensity resistance training, such as Crossfit or Spinning. However, it is difficult to assess, since it does not have universally accepted laboratory and/or clinical criteria for diagnosis. Exercise-induced rhabdomyolysis is generally defined as a clinical-laboratory syndrome that results from the lysis of skeletal muscle cells, with the release of intracelular substances into circulation. Patients have a combination of muscle associated symptoms (myalgia, weakness and edema), in conjuction with a substantial increase in serum creatine kinase, after physical activity. Rhabdomyolysis can also occur due to trauma, seizures, consumption of alcohol or drugs, among other causes. When recurring, it is also important to consider the existence of inherited metabolic diseases, which increases the risk of rhabdomyolysis. The treatment essentially consists of instituting fluid therapy – oral or intravenous, depending on the severity of the disease -, and the use of sodium bicarbonate can also be considered, in order to prevent myoglobin precipitation in the renal tubules. This syndrome has a good prognosis, since must patients recover without any complications. However, its main complications are acute kidney injury, compartimental syndrome and disseminated intravascular coagulation. Therefore, this dissertation aims to review the existing literature on exerciseinduced rhabdomyolysis, with a greater focus on the resulting renal complications.
Description
Keywords
Abdomiólise Esforço Exercício Físico Insuficiência Renal Rim