Rhabdomyolysis in Earthquake Victims in Nepal

C rush injury leading to rhabdomyolysis is one of the dreaded complications of natural catastrophes such as earthquakes. Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents, namely creatine phosphokinase, myoglobin, and various electrolytes into the circulation. Precipitation of myoglobin in the renal tubules with secondary obstruction and/or tubular toxicity constitutes one of the main causes of acute kidney injury (AKI). 5 Creatine phosphokinase (CPK), a widespread enzyme that catalyzes the phosphorylation of creatinine into creatinine phosphate, is an enzyme released into the bloodstream from injured muscle tissue. The skeletal muscle has a very high CPK content. It is present in the serum immediately following muscle injury, peaks at about 12 to 36 hours, and has a half-life of about 48 hours. However, every crush injury does not necessarily result in rhabdomyolysis, and not