Authors' Reply: Rhabdomyolysis-Induced Acute Kidney Injury in Austere Environments Highlights Need for Specific Treatment.
Authors' Reply: Rhabdomyolysis-Induced Acute Kidney Injury in Austere Environments Highlights Need for Specific Treatment.
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DOI：
10.1016/j.ekir.2023.04.007
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发表时间：
2023-06
影响因子：
6
通讯作者：
Hutchens, Michael P.
中科院分区：
文献类型：
--
作者：
Hebert, Jessica F.;Hutchens, Michael P.
作者回答：我们要感谢Govindan、Fernando和Kurien博士对横纹肌溶解所致急性肾损伤(RIAKI)的机制和新兴治疗方法的回顾。横纹肌溶解有多种病因，包括挤压伤S1、过度运动S2、病毒感染(包括新冠肺炎)S3、S4或药物使用S5；然而，任何导致骨骼肌破坏的损伤都可能是RIAKI的可归因性原因。我们同意他们的断言，即来自多种动物物种的毒液，包括蛇和黄蜂，可以导致横纹肌溶解和随后的急性肾脏损伤(AKI)。S6，S7由于损伤的危急性质和在农村等严酷的医疗环境中发生的频率，毒液诱导的RIAKI是一种重要的病因学，应该有助于寻找新的治疗方法。作者描述了一名46岁的男性患者，其继发于钩端螺旋体感染的急性肾小管损伤，此前在人类中与AKI有关，2在豚鼠模型中与RIAKI有关。3急性肾损伤合并低血压，在病因确定前，通过血肌酐升高和肾活检确诊。免疫组织化学和马森氏三色染色观察到的管状铸型是RIAKI的主要观察结果。他们在图1中发现的肾小管上皮损伤非常有趣，因为正如我们的综述所讨论的那样，在血流中释放的肌肉代谢物很容易被肾小球过滤并进入近端小管。小管的内壁是表达巨蛋白的上皮细胞，这些细胞内吞肌红蛋白。4、S8在细胞内，损伤是由游离铁介导的活性氧产生所致。
The Author Replies: We would like to thank Drs. Govindan, Fernando, and Kurien for their interest in our review of the mechanisms and emerging therapies for rhabdomyolysis-induced acute kidney injury (RIAKI). 1 Rhabdomyolysis has multiple etiologies, including crush injuryS1, overexertionS2, viral infection (including COVID-19) S3, S4, or drug useS5; however, any injury resulting in the destruction of skeletal muscle can be an attributable cause of RIAKI. We agree with their assertion that venom from multiple animal species, including snakes and wasps, can cause rhabdomyolysis and subsequent acute kidney injury (AKI). S6, S7 Because of the critical and urgent nature of the injury and frequency in austere medical environments such as rural areas, venom-induced RIAKI is an important etiology that should inform efforts to derive novel treatment.The authors describe a 46-year-old male patient presenting with acute tubular injury secondary to leptospirosis infection, which has been previously linked to AKI in humans, 2 and RIAKI in a guinea pig model. 3 AKI associated with hypotension, was identified by elevated serum creatinine and renal biopsy before the etiology was confirmed. Tubular casts observed by immunohistochemistry and Masson’s trichrome are cited as principal observations for the resultant RIAKI. Their finding of tubular epithelial injury in Figure 1 is very interesting because, as our review discusses, muscle metabolites released in the bloodstream are readily filtered by the glomerulus and enter the proximal tubule. Lining the tubule are megalin-expressing epithelial cells which endocytose myoglobin. 4, S8 Intracellularly, injury results from free iron-mediated production of reactive oxygen species.
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影响因子：
3.8
作者：
Abreu PAE;Seguro AC;Canale D;Silva AMGD;Matos LDRB;Gotti TB;Monaris D;Jesus DA;Vasconcellos SA;de Brito T;B Magaldi AJ
通讯作者：
B Magaldi AJ
影响因子：
6
作者：
Hebert, Jessica F.;Burfeind, Kevin G.;Malinoski, Darren;Hutchens, Michael P.
通讯作者：
Hutchens, Michael P.
影响因子：
13.6
作者：
Matsushita, Katsuyuki;Mori, Kiyoshi;Hutchens, Michael P.
通讯作者：
Hutchens, Michael P.
影响因子：
3.5
作者：
Araujo, Eduardo Rocha;Seguro, Antonio Carlos;De Brito, Thales
通讯作者：
De Brito, Thales