Insights on the practical application of the current treatment consensus in rhabdomyolysis management: a case report

TL;DR

A case report shows successful treatment of severe rhabdomyolysis using hemoadsorption alongside standard care, leading to full kidney recovery.

Contribution

Demonstrates practical application of hemoadsorption in rhabdomyolysis treatment aligned with recent consensus guidelines.

Findings

Combined CRRT and hemoadsorption successfully treated severe rhabdomyolysis.

Monitoring myoglobin levels before and after adsorption aided therapy assessment.

Patient regained full renal function and mobility after treatment.

Abstract

Hemoadsorption has emerged as a promising adjunctive therapy in the management of various inflammatory and toxin-mediated conditions. Its role in context of rhabdomyolysis has generated increasing scientific and clinical interest. In response to the recent consensus statement by an international expert task force—published in BMC Nephrology in July 2024—regarding the use of hemoadsorption in rhabdomyolysis, we aim to contribute further to this evolving discourse.

We report on a patient with severe rhabdomyolysis secondary to influenza B infection who suffered acute kidney injury (AKI) as a result. Alongside conservative treatment, we successfully implemented a combined regimen of CRRT and hemoadsorption, while using myoglobin levels up- and downstream of the adsorber as a tool for therapy monitoring. The patient subsequently recovered complete renal function and full body mobility.

The case illustrates the practical implementation of hemoadsorption within a multimodal treatment strategy. In addition to demonstrating concordance with current consensus guidelines, we seek to critically discuss potential refinements in the therapeutic approach—particularly concerning monitoring strategies and the integration of extracorporeal modalities—to facilitate future clinical practice and research.

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