Insuficiência Renal Aguda e Rabdomiólise Induzida pelo Uso de Estatina. Relato de Caso* Acute Renal Failure and Rhabdomyolysis Induced by Statin. Case Report

SUMMARY BACKGROUND AND OBJECTIVES: The ability of statins to reduce the risk of cardiovascular morbimortality in patients with dyslipidemia is well established. The adverse effects associated with statins are usually mild and transient. The most noteworthy adverse effects associated with statins are elevations in liver transaminasis, myopathy and rhabdomyolysis, which is characterized by massive muscle necrosis, myoglobinuria and acute renal failure. In general, statins are associated with a very small risk of myopathy (with may progress to fatal or nonfatal rhabdomyolysis). The incidence is dose related and is increased when statins are used in combination with agents that share common metabolic pathways. Acute renal failure is the most serious complication of rhabdomyolysis and the main cause of death. Early recognition and treatment may prevent the progression of rhabdomyolysis. CASE REPORT: A 57 year-old-man, with no history of renal dysfunction presented with acute renal failure and rhabdomyolysis induced by high-dose statin (simvastatin 80 mg/day). CONCLUSION: Clinicians should be alert for drug-drug interactions to minimize the risk of myopathy. The prescribing physician should consider the co-morbid risk factors, including polypharmacy, and initiate statin at a lower dose in the elderly. If rhabdomyolysis is suspected the statin therapy should be withdrawn.