| Related Articles |
Creatinine as predictor value of mortality and acute kidney injury in rhabdomyolysis.
Intern Med J. 2015 May 26;
Authors: Baeza-Trinidad R, Brea-Hernando A, Morera-Rodriguez S, Brito-Diaz Y, Sanchez-Hernandez S, El Bikri L, Ramalle-Gomara E, Garcia-Alvarez JL
Abstract
INTRODUCTION: Rhabdomyolysis (RB) is a syndrome characterized by decomposition of skeletal muscle that could be life threatening, so the identification of biomarkers of its severity could help us in its treatment. Creatinkinase (CK) is usually taken as a reference in patients with RB in order to stratify prognosis, however that is not probably the most effective parameter. The present study was designed to analyse the specific features and mortality of patients with RB and the relation between creatinine, creatinkinase and mortality.
METHODS: retrospective cohort analysis among patients admitted to San Pedro Hospital in Logroño (Spain) with RB (CK levels higher than 2000 U / L) diagnosed since January 1, 2009 until December 31, 2013522 patients with RB patients diagnosed of RB were collected. One year mortality and was studied. The etiology and the analytical features (creatinine, CK, calcium, phosphorus, pH and bicarbonate) as well as one-year mortality was investigated.
RESULTS: Among the 522 patients, there were 138 deaths. Four patients required renal replacement therapy. The most common cause of RB was trauma (29%). Infectious etiology had the highest mortality (41.2%). The median CK was 3451 u/L (interquartile range 3348) and the mean creatinine at admission was 132.6 umol/L (± 110.5). Initial CK levels does not have predictive ability on mortality or renal dysfunction in contrast to initial creatinine values. Each state of AKI increased mortality compared with those who have not presented this renal dysfunction (p < 0.0001). Age, calcium, phosphorus, bicarbonate and pH are associated with AKI.
DISCUSSION: Despite being a diagnostic marker for RB, initials CK levels do not predict mortality. However, creatinine initial levels are related to progression to acute renal injury and mortality at 30 days.
PMID: 26010490 [PubMed - as supplied by publisher]