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Paddling injuries

A muscle condition that injures the kidneys is well-known to football experts — diagnosed recently in a professional player and 13 college athletes. Yet new studies are finding some surprising sources of rhabdomyolysis, the potentially deadly condition, according to research being presented at the National Kidney Foundation’s Spring Clinical Meetings, held here this week.

This condition causes muscles to break down, releasing their fibers and enzymes into the body. These enter the bloodstream and plug up the kidney, resulting in potentially fatal damage. Recently, the condition was diagnosed in Washington Redskins player Albert Haynesworth and 13 players on an Iowa college team, as well as two dozen high school football players in Oregon. In these cases, the condition – often called simply “rhabdo” – is attributed to intense workouts, injury, or heat exhaustion. But there are less obvious causes that can put even non-athletes at risk.

One group of researchers presented findings from a 19-year-old man who developed rhabdo after being hazed by his fraternity. As part of the hazing, he was struck in the back and buttock areas up to 1,000 times with wooden paddles, injuring the muscles and triggering rhabdomyolysis.

“This is yet another reason why hazing can be deadly,” said study author Dr. Khalid Bashir of the Morehouse School of Medicine. Thankfully, with treatment, the man survived. “The strange thing is that the patient entered a fraternity thinking his brothers would protect him from other people,” said Dr. Bashir. “When, in fact, it was the other way around.”

In another study, Dr. Gaurav Alreja at Baystate Medical Center and his colleagues describe a man who developed rhabdo after taking the combination of a cholesterol-lowering drug and an antibiotic.

Previous research has shown that these cholesterol-lowering drugs, known as statins, can increase the risk of rhabdo, explained Dr. Alreja. In this instance, a 73-year-old man on a relatively high dose of simvastatin developed rhabdo after he added the antibiotic azithromycin – a common drug thought to be very safe, he explained.

“This patient likely had some predisposition to developing rhabdomyolysis, and the high dose of the statin increased that risk – adding this antibiotic likely tipped the balance,” said Dr. Alreja. “Hopefully, doctors and patients will keep this interaction in mind when offering antibiotics to patients receiving statins.”

Thankfully, the patient recovered, and was able to continue taking high-doses of statins without the antibiotic, and the rhabdo did not return.

In another less fortunate report, doctors describe a 24-year-old man who died after developing rhabdomyolysis as a complication from anesthesia. The man had been under anesthesia for days following a car accident, and patients in this situation are sometimes at risk of developing propofol infusion syndrome (PRIS), a series of complications resulting from the anesthetic propofol.

In this instance, the patient developed rhabdomyolysis as well, and died.

Many people – even doctors – may not be aware that PRIS can cause rhabdomyolysis, and hopefully this man’s tragedy will help change that, said study author Dr. Tamim H. Naber of the Hofstra North Shore-LIJ School of Medicine. “Knowledge of this rare condition is important to help diagnose the condition early, and potentially stop the course of the disease,” said Dr. Naber.

“These studies illustrate the importance of overall awareness of the many uncommon causes of rhabdomyolysis, which can have devastating effects on athletes and non-athletes alike,” said Dr. Lynda Szczech, National Kidney Foundation President.

Source:
National Kidney Foundation

By Hank Nuwer

Journalist Hank Nuwer is the Alaska author of Hazing: Destroying Young Lives; Broken Pledges: The Deadly Rite of Hazing, High School Hazing, Wrongs of Passage and The Hazing Reader. He has written articles or columns on hazing for the Sunday Times of India, Toronto Globe & Mail, Harper's Magazine, Orlando Sentinel, The Chronicle of Higher Education and the New York Times Sunday Magazine. His current book is Hazing: Destroying Young Lives from Indiana University Press. He is married to Malgorzata Wroblewska Nuwer of Warsaw, Poland and Fairbanks, Alaska. Nuwer is a former columnist for the Greenville (Ohio)Early Bird and former managing editor of the Fairbanks Daily News-Miner in Alaska.
Nuwer was named the Ohio Society of Professional Journalists columnist of the year in 2021 for his “After Darke” column in the Early Bird. He also won third place for the column in 2022 from the Indiana chapter of the Society of Professional Journalists. He and his wife Gosia, recently of Union City, Ind., have owned 20 acres in Alaska for many years. “The move is a sort-of coming home for us,” said Nuwer. As a journalist, he’s written about the Alaskan Iditarod sled-dog race and other Alaska topics. Read his musings in his blog at Real Alaska Daily--http://realalaskadaily.com and in his weekly column "Far from Randolph" in the Winchester Star-Gazette of Randolph County, Indiana.

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