Managing myoglobin levels to support kidney health
Rhabdomyolysis results in the release of myoglobin into the bloodstream. Excessive myoglobin can accumulate in the kidneys and is associated with the development of acute kidney injury (AKI).
CytoSorb® in severe Rhabdomyolysis
In cases of severe rhabdomyolysis, large amounts of myoglobin are released into the bloodstream and can contribute to the development of acute kidney injury (AKI).
CytoSorb® Therapy is an extracorporeal hemoadsorption technology designed to remove selected middle-molecular-weight and hydrophobic substances such as myoglobin and cytokines from blood or plasma.
It can be applied alongside conventional renal-replacement therapies as part of a multimodal treatment approach aimed at supporting blood purification and reducing the burden of circulating inflammatory and muscle-derived molecules, thereby targeting preservation and recovery of renal function.
CytoSorb® is designed to support extracorporeal management in patients with severe rhabdomyolysis
Manage rhabdomyolysis
CytoSorb has been shown to effectively and safely remove elevated levels of myoglobin, while additionally addressing any concomitant hyperinflammation, helping in the management of rhabdomyolysis.
Rhabdomyolysis can cause serious damage:
Rapid breakdown of the skeletal muscles
Myoglobin released into the bloodstream
Myoglobin accumulates in renal tubules
Excessive myoglobin levels may result in:
- Oxidative stress
- Inflammatory response
- Endothelial dysfunction
- Renal vasoconstriction
- Apoptosis
- Cellular and granular casts
As a consequences this may result in AKI - Akute Kidney injury
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Rapid breakdown of the skeletal muscles
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Myoglobin released into the bloodstream
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Myoglobin accumulates in renal tubules
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Excessive myoglobin levels may result in:
- Oxidative stress
- Inflammatory response
- Endothelial dysfunction
- Renal vasoconstriction
- Apoptosis
- Cellular and granular casts
-
As a consequences this may result in AKI - Akute Kidney injury
CytoSorb® Therapy adsorbs elevated levels of myoglobin, supporting blood purification in patients with rhabdomyolysis and kidney stress.
Effective myoglobin removal
Superior performance vs standalone HCO-filter
Supporting control of hyperinflammatory responses
Rhabdomyolysis
Treatment goals & Rationale
Protect your patient’s kidneys from massive myoglobin release
Intercept excess myoglobin early, accelerate its removal from the bloodstream, prevent cast formation in the renal tubules, reduce both local and systemic inflammation, and support the preservation and recovery of kidney function.
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Addressing the challenges of excessive myoglobin release
Forni et al.Remove myoglobin through direct adsorber binding
Once released in high concentrations, myoglobin induces damage to the proximal tubuli via reactive oxygen species, reducing excretory function, while myoglobin precipitations block the distal tubuli. AKI occurs in up to 40% of affected pts.
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Designed to complement existing therapies
Chavez et al.Reduce fluid (over)loading and need for enforced diuresis
Diuretics such as furosemide plus NaCI infusion are meant to dilute “the problem” and enforce urine production; however this might add further pressure to the distal tubuli as they are blocked with myoglobin casts, while high amounts of fluids might stress the cardiac system of specific patients.
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Support dialysis procedures
Albrecht et al.Overcomes the filtration limits of dialysers/HCOs
Filtration systems are destined for long, slow myoglobin removal; but to alleviate the imminent pressure on the kidneys, more potent adsorbers should be considered as first choice for early & forceful relief
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Supporting the control of systemic inflammation processes
Jansen et al.Safeguard renal parenchym from DAMPs/mediators
The ability of hemoadsorption technologies to remove such mediators from blood or plasma represents a mechanistic complement to filtration-based therapies in managing patients with severe inflammatory responses.
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Supporting the maintenance of organ function
Graefe et al.Normalize kidney filtration capacity and urin production
Unburdening quickly from myoglobin and inflammation, both contributing to AKI development, is the ultimate therapy goal and likewise rationale for a treatment approach with CytoSorb.
Additional Information
- Albrecht et al., Blood Purif 2024; 53(2):88-95
- Grafe et al., Ren Fail 2023; 45(2):2259231
- Scharf et al., Crit Care 2021; 25(1):41
- Chavez et al., Crit Care 2016; 20(1):135
- Boutaud et al., Proc Natl Acad Sci USA 2010; 107(6):2699-704
- Bosch et al., N Engl J Med 2009; 361(1):62-72
- Khan et al., Neth J Med 2009; 67(9):272-283
- Chatzizisis et al., Eur J Intern Med 2008; 19(8):568-574
- Jansen et al., Crit Care 2023; 27(1):117
- Weidhase et al., BMC Nephrology (2025) 26:23
- Graf et al., Annals of Intensive Care 2024; 14(1):96
- Forni et al., BMC Nephrology 2024; 25(1):247
CytoSorb 300 IFU 03/2023 – Indications:
CytoSorb is indicated for use in conditions where elevated levels of cytokines and/or bilirubin and/or myoglobin exist. CytoSorb is indicated for use intraoperatively during cardio-pulmonary bypass surgery for the removal of P2Y12-Inhibitor Ticagrelor and/or Factor Xa-Inhibitor Rivaroxaban. Results from current studies suggest that CytoSorb may be administered for up to 7 consecutive days. Maximum Treatment Time per Device: 24 Hour.
Voices around the world
Access Healthcare Professionals Area
This area is for Health Care Professionals only and provides reports about clinical experiences gained during the use of CytoSorbents products. The information presented reflects the opinions and procedural techniques of individual physicians and is not intended as medical advice. Physician experience, risks, patient outcomes and results may vary. This content is intended for Health Care Professionals outside the United States and Canada as CytoSorb has not yet been approved or cleared in the United States or Canada for any indication, except under an Emergency Use Authorization (EUA) by the US FDA.