ABSTRACT
Rhabdomyolysis is one of the leading causes of acute renal failure. The cytotoxic effect of myoglobin is one of the major injury pathways in developing of renal insufficiency in this clinical disorder. Oxidative stress plays a critical role in the development of this nephrotoxic effect. Because iron is incriminated as the critical initiator of heme induced proximal tubular cytotoxicity, it has been demonstrated that iron chelator, desferoxamine, can play a protective effect in this type of renal injury in experimental studies. The aim of this work was to study the effect of oxidative stress on renal functions in traumatic rhabdomyolysis patients and trying to evaluate the protective effect of desferoxamine [DFO] in these patients. Twenty patients with extensive muscle trauma and diagnosed as rhabdomyolysis by high serum CK and myoglobin were included in this study. Patients were classified into 2 groups: Group I that received desferoxamine plus conventional therapy in the form of fluids, mannitol, sodium bicarbonate and Group II that received conventional therapy alone. These 20 patients were compared to 10 normal subjects as a control group. All subjects were subjected to full history taking, complete clinical examination and scoring which is done for the patients only. Laboratory tests were done including blood urea, serum creatinine as well as estimation of serum CK, serum myoglobin, serum MDA and blood glutathione. Laboratory tests were done twice for the 20 patients, one on admission and another one 24 hours after treatment. Results revealed that oxidative stress developed in our twenty patients as evidenced by high MDA and reduced glutathione 24 hours after admission. This oxidative stress was less in the patients received desferoxamine when compared with those who did not receive desferoxamine. There were also better renal functions in the desferoxamine group in comparison to the non desferoxamine group. It was concluded that desferoxamine as an iron chelator, decreases the oxidative stress in traumatic rhabdomyolysis patients and recommended to be used on a larger scale before being standardized