Severe rhabdomyolysis with renal failure after intranasal cocaine use

B. Zane Horowitz, Edward A. Panacek, Nicholas J. Jouriles

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36 Scopus citations


A case of acute renal failure due to rhabdomyolysis in a patient who used cocaine on a daily basis is presented. In contrast to many prior reports of renal failure occurring with cocaine-associated rhabdomyolysis, our patient did not use intravenous cocaine and did not have any evidence of trauma, seizure, hypotension, hyperthermia, hyperactivity, or coma. His creatine phosphokinase peaked at 448,000 U/liter. He was treated initially with forced diuresis and i.v. furosemide, but he became oliguric, developed pulmonary edema, and required hemodialysis. He recovered fully after 3 weeks of dialysis. The literature is reviewed in an attempt to delineate a rational approach to evaluating cocaine users at risk for rhabdomyolysis.

Original languageEnglish (US)
Pages (from-to)833-837
Number of pages5
JournalJournal of Emergency Medicine
Issue number6
StatePublished - Nov 1997


  • Cocaine
  • Creatinine kinase
  • Myoglobin
  • Renal failure
  • Rhabdomyolysis

ASJC Scopus subject areas

  • Emergency Medicine


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