Renal protection with recombinant b-type natriuretic peptide in a burn patient with rhabdomyolysis

Abstract

Rhabdomyolysis is a complication of injury to muscle, which may lead to acute renal failure (ARF) [1]. Although most commonly associated with crush injury [2], rhabdomyolysis is a common sequela to the direct and inflammatory injuries seen in burn patients [3]. Multiple fluid regimens and pharmaceutical agents have been used to attempt to reduce the very high risk of renal failure in patients with rhabdomyolysis [4–11], with limited success. The application of an endogenous homeostatic peptide, recombinant b-natriuretic peptide (rBNP) as a renoprotective agent is physiologically and therapeutically attractive strategy in this setting because it is a renal vasodilator, natriuretic, and inhibitor of renin secretion. We present a case in which rBNP was used as adjunctive therapy in the successful prevention of ARF in a patient with rhabdomyolysis and acute renal decompensation.