XXXX , myoglobinuria and exercise.

@entity2700 @entity121 @entity908 @entity425 @entity5632 @entity520 @entity5925 @entity42948 @entity2054 @entity209 @entity925 @entity166
Muscle membrane injury is a predictable consequence of extreme exertion. The risk is compounded if an untrained individual performs eccentric exercise in a hot environment, or there is any preceding @entity166 , drug ingestion or an underlying @entity209 . Once the integrity of the membrane is breached, a constellation of physiological changes follows. Cell contents leak out and extracellular components leak in. @entity925 and @entity425 ensue. @entity5632 is but one substance that is liberated into the bloodstream. When @entity2700 , hypovolaemia and @entity520 are added to the @entity5632 load, the kidney may respond by ceasing its excretory and metabolic functions. This is the most serious consequence of @entity5925 , and may be life threatening. The clinical setting, in combination with laboratory features of a grossly elevated @entity908 kinase, @entity42948 positive urine and granular casts provides a rapid and accurate means of diagnosis in most cases. Management principles include aggressive fluid replacement, early use of cation exchange resins and dialysis for electrolyte control, plus fasciotomy for relief of @entity2054 and limb preservation. Following this protocol, the prognosis is excellent. Prior conditioning clearly reduces the incidence of exercise-related @entity121 . Future research should concentrate on the rate at which training loads can be safely increased.
