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=====Hyperkalemia<ref name="pmid28846335">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=28846335 | doi= | pmc= | url= }} </ref>=====
=====Hyperkalemia<ref name="pmid28846335">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=28846335 | doi= | pmc= | url= }} </ref>=====


*'''Potassium levels less than 6 mEq/L without EKG changes:''' managed with potassium binders, and use of bicarbonate in fluids
*'''Potassium levels less than 6 mEq/L without EKG changes:''' managed with potassium binders, and use of bicarbonate in fluids.
*'''Potassium levels 6 mEq/L or above with or without EKG changes:''' ampule of D50 followed by zero units of regular insulin, and IV sodium bicarbonate.
*'''Potassium levels 6 mEq/L or above with or without EKG changes:''' ampule of D50 followed by zero units of regular insulin, and IV sodium bicarbonate.



Revision as of 20:47, 25 April 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: M. Hassan, M.B.B.S

Overview

The medical therapy of Haff disease consists of managing rhabdomyolysis by aggressive fluid hydration, managing electrolyte abnormalities (hyperkalemia and hypocalcemia), and other supportive care.

Medical therapy

Management of Rhabdomyolysis

The goal of rhabdomyolysis is adequate fluid hydration with normal isotonic saline to prevent acute kidney injury. Urine output of 200 to 300 mL/h should be maintained with daily serial monitoring of CPK level to document a downward trend. In case of fluid overload from aggressive fluid resuscitation, loop diuretics may be considered.[1] In severe cases with CPK level > 30,000 IU/L, alkalization of the urine with bicarbonate can be considered.[1][2]

Management of Electrolytes Abnormalities

Rhabdomyolysis is associated with hyperkalemia and hypocalcemia.[1]

Hyperkalemia[1]
  • Potassium levels less than 6 mEq/L without EKG changes: managed with potassium binders, and use of bicarbonate in fluids.
  • Potassium levels 6 mEq/L or above with or without EKG changes: ampule of D50 followed by zero units of regular insulin, and IV sodium bicarbonate.
Hypocalcemia[1]

Other Supportive Care[1]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 "StatPearls". 2022. PMID 28846335.
  2. Pei P, Li XY, Lu SS, Liu Z, Wang R, Lu XC; et al. (2019). "The Emergence, Epidemiology, and Etiology of Haff Disease". Biomed Environ Sci. 32 (10): 769–778. doi:10.3967/bes2019.096. PMID 31843046.