Rhabdomyolysis: a 10-year retrospective study of patients treated in a medical department

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Abstract

Background

Rhabdomyolysis is a common and potentially life-threatening syndrome, and acute kidney injury (AKI) is a serious complication. We performed a 10-year retrospective study that included all patients treated for rhabdomyolysis in a medical clinic. We examined the relationships between the levels of creatine kinase (CK), myoglobin, and creatinine (as a marker of renal function and thereby AKI), and whether the myoglobin/CK ratio could be a valuable tool in the clinical evaluation of this patient group. Clinical characteristics were noted.

Patients and methods

The study included all patients treated for rhabdomyolysis in the Department of Medicine, Oslo University Hospital Ulleval, from 2003 to 2012. Rhabdomyolysis was defined as a serum CK activity more than five times the upper reference limit.

Results

A total of 341 patients were included in the study; 51% developed AKI, and 20% of those required dialysis. Logistic regression showed that myoglobin concentration [P<0.001, odds ratio (OR)=6.24] was a better predictor than CK activity (P=0.001, OR=3.45) of the development of AKI. The myoglobin/CK ratio was a good predictor of AKI (P<0.001, OR=5.97). The risk of developing AKI increased with increasing myoglobin/CK ratio (P<0.001); a ratio more than 0.2 was associated with an increased likelihood of developing AKI.

Conclusion

Serum myoglobin concentration was a better predictor of AKI than was serum CK activity. The myoglobin/CK ratio may be useful for assessing the likelihood of developing AKI.

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