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July 1979

The Effect of Infusion of Mannitol-Sodium Bicarbonate on the Clinical Course of Myoglobinuria

Author Affiliations

From the University of California Renal Center at San Francisco General Hospital and the Department of Medicine, University of California Medical Center, San Francisco.

Arch Intern Med. 1979;139(7):801-805. doi:10.1001/archinte.1979.03630440059020

Twenty patients who had evidence of myoglobinuria were treated with intravenous infusions of mannitol and sodium bicarbonate. Nine patients (group 1) responded with higher urine output, and continued infusion improved renal function; none required dialysis and all survived. Eleven patients (group 2) did not respond to the infusion, and required an average of 5.3 (range, 0 to 11) dialyses; one patient died. There was no significant difference in initial BUN level, creatinine level, BUN/ creatinine ratio, or fractional sodium excretion level between the two groups. However, group 2 patients had a significantly higher creatine phosphokinase (CPK) level, serum phosphate level, and hematocrit reading initially than did group 1, indicative of more severe muscle injury and hemoconcentration. These results demonstrate that some patients with myoglobinuria will respond to infusion of mannitol and sodium bicarbonate. This treatment may be effective in altering the clinical course of myoglobinuric acute renal failure.

(Arch Intern Med 139:801-805, 1979)

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