100 g) excess myoglobin is .filtered by the kidneys and can cause renal tubular obstruction and renal damage: the excess myoglobin is nephrotoxic. intravascular volume depletion and renal hypoperfusion, combined with myoglobinuria, result in renal dysfunction.2 Crush syndrome is characterised by Hypovolaemic shock (due to sequestration of water in the injured muscle cells). Hyperkalaemia (release of cellular potassium by the injured muscle cells). This can also lead to: - Metabolic acidosis (release of cellular phosphate and sulphate by the injured muscle cells) - Acute renal failure - Disseminated intravascular coagulation (DIC) The key clinical_ features of crush syndrome are : Crushing injury to a large mass of skeletal muscle. Sensory and motor disturbances in the compressed limbs, which subsequently become tense and swollen Myoglobinuria and/or haemoglobinuria Raised creatine kinase There may be oliguria Elevated levels of urea, creatinine, uric acid, potassium, phosphate Thpocalcaemia">