POSTOPERATIVE RHABDOMYOLYSIS IN PATIENTS WITH END-STAGE RENAL-FAILURE

Four patients with end-stage renal failure on intermittent hemodialysi s in whom rhabdomyolysis developed after major surgery are described. This possibly underdiagnosed complication was manifested by extreme hy perphosphatemia, hypocalcemia, and elevated creatine phosphokinase lev els. Serum myoglobin levels further supported the diagnosis. The metab olic abnormalities reached a peak on the fourth postoperative day. The possible precipitating factors included opiates used for anesthesia a nd postoperative pain central, anesthetic agents, and surgical positio n. The preferred treatment option is increasing dialysis to control hy perphosphatemia and hypocalcemia. (C) 1998 by the National Kidney Foun dation, Inc.