A 20-year-old male with massive rhabdomyolysis associated with a high fever and acute renal failure is reported. Influenza A infection was confirmed serologically. Myoglobin kinetics was studied in this case. Blood myoglobin fell exponentially independent of renal function or therapeutic modality such as hemodialysis/filtration, once myoglobin release into the circulation ceased. The finding suggested that catabolic steps of myoglobin take place extrarenally in patients with massive rhabdomyolysis and acute renal failure.
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Wakabayashi et al. (1994) studied this question.