Abstract: SA-PO044

The Effect of a Hourly Urine Output on the Clinical Outcomes in Nontraumatic Exercise-Induced Rhabdomyolysis

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Shin, Won jae, Konkuk University Medical Center, Seoul, Korea (the Republic of)
  • Ko, Young kyung, Konkuk University Medical Center, Seoul, Korea (the Republic of)
  • Jo, Young-Il, Konkuk University Medical Center, Seoul, Korea (the Republic of)
Background

Rhabdomyolysis-induced renal failure is a relatively rare condition, but its clinical consequences are occasionally serious and dramatic. Early and aggressive fluid resuscitation is commonly used to prevent renal failure in rhabdomyolysis. However, the optimal fluid and rate of repletion are unclear. The purpose of this study is to evaluate the effect of the degree of urine output following fluid repletion on the clinical outcomes in nontraumatic exercise-induced rhabdomyolysis (EIR).

Methods

The medical records of all nontraumatic EIR patients admitted to Konkuk University Medical Center between 2011 and 2015 were reviewed. After establishing a definitive diagnosis of nontraumatic EIR, fluid infusion was promptly initiated, with the goal of maintaining a urinary flow of 150-300 mL/h according to existing protocol.

Results

Total 45 cases were analyzed. Patients were categorized according to the hourly urine output during initial 48 hours following fluid resuscitation: the high urine output (≥200 mL/hr) and the low urine output (<200 mL/hr) group. No significant differences were noted between two groups in initial levels of CPK, serum myoglobin, and creatinine. The fluid rate of initial repletion was significantly higher in the high urine output group (4.6±1.5 vs. 2.5±0.7 mL/kg/hr, p<0.001). The hourly urine output was also significantly high in the high urine output group (307.5±116.6 vs. 138.7±42.8 mL/hr, p<0.001). There was no differences in the clinical outcomes including maximal level of CPK, incidence of AKI and mean hospital stay between two groups (Table).

Conclusion

Our results indicated early fluid resuscitation, even though a urine output was less than 200 mL/hour, was effective for prevention of acute kidney injury in nontraumatic exercise-induced rhabdomyolysis. A prospective, controlled, multicenter trial is necessary to determine optimal fluid therapy to prevent acute kidney injury in nontraumatic EIR.