THE IMPACT OF RHABDOMYOLYSIS INDUCED AKI ON PATIENT OUTCOMES

Introduction:

Rhabdomyolysis is a clinical syndrome characterized by the breakdown of skeletal muscle cells and release of creatine kinase (CK), lactate dehydrogenase (LDH), and myoglobin into the plasma and interstitial space. Rhabdomyolysis causing AKI incidence 10-40% . Rhabdomyolysis can occur due to various reasons, such as traumatic injuries, muscle compression, genetic muscle disorders, prolonged immobilization, extreme exertion, drug abuse, or certain infections.

Methods:

Here we included patients who were clinically suspected to have rhabdomyolysis confirmed by laboratory parameters ,who have been admitted through emergency with varied presentation, we have included patient who are adults who have had AKI -as per KDIGO definition and staging labs  showing elevated levels of CPK  5 times the normal value ,raised LDH levels .patient who are already CKD ,without any AKI ,paediatric patients were excluded from the study 

Results:

A cohort of 28 patients with acute kidney injury (AKI) and Rhabdomyolysis was analyzed. The majority were male (70%), with a mean age of 45. Common comorbidities included hypertension and diabetes. Laboratory findings revealed elevated creatinekinase (CK)with levels of 18,250 ± 5,000 U/L, LDH: 342 ± 25 U/L and Creatinine: 3.5 ± 1.0 mg/dL with positive urine myoglobin. AKI staging according to KDIGO criteria showed a distribution of 25% in Stage 1, 35% in Stage 2, and 40% in Stage 3. The most frequent etiologies were Trauma 30%, Seizures 20%, Drug-induced (statins, baclofen, alcohol) 30%, Exertion/heat 13.3%with Rare ethologies being Scrub typhus 3.3%, Acute pancreatitis 6.6%, SLE flare 3.3%, Anabolic steroid abuse3.3%.Approximately 40% of patients required hemodialysis, with 43%having complete renal recovery ,21% becoming CKDIIIa/IIIb 7% CKDV dialysis dependent with 29% of the patient lost follow up.The overall mortality rate was 13.3%.

Conclusions:

Rhabdomyolysis often presents with nonspecific symptoms, necessitating a high index of clinical suspicion for timely diagnosis and treatment. Early intervention, including fluid resuscitation, renal replacement therapy (RRT) when indicated, and addressing the underlying cause, is crucial to prevent complications. Most patients with promptly treated rhabdomyolysis experience full renal recovery, although RRT may be necessary in some cases. Overall, the prognosis for rhabdomyolysis is generally favourable with appropriate management.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.