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Kidney Week

Abstract: TH-PO037

Body Composition for Predicting Exertional Rhabdomyolysis-Induced AKI During Intensive Physical Training Program for Military Recruits

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Maniyan, Chaken, Phramongkutklao hospital, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao hospital, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao hospital, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao hospital, Bangkok, Thailand
  • Supasyndh, Ouppatham, Phramongkutklao hospital, Bangkok, Thailand
Background

Exertional rhabdomyolysis-induced acute kidney injury (AKI) is a life-threatening condition. The risk factors for developing this condition are partially documented and changing in the body composition of these population is still poorly understood.

Methods

A prospective cohort study in the military recruits between May to July 2017 were conducted. Demographic and laboratory data including body mass index (BMI), serum creatinine, electrolyte, creatine phosphokinase (CPK), and body composition using dual frequency body impedance analysis (BIA) were measured before training and every 2 weeks until program had been completed.

Results

Total of 301 participants with mean age of 22 ± 2.5 years old were included. The incidence of exertional rhabdomyolysis-induced AKI was 19.2 %. At baseline, subjects who developed exertional rhabdomyolysis-induced AKI had lower frequency of exercise before recruitment (1.02 ± 0.13 times/week vs 3.49 ± 0.93 times/week, p <0.001) , lower total body water (TBW) (45.08 ± 2.95 % vs 54.31 ± 5.21%, p < 0.001) and lower plasma potassium (3.6 ± 0.3 mEq/L vs 4.0± 0.4 mEq/L, p < 0.001). Along the course of training, AKI group had a significant loss of muscle mass (-5.65 ± 2.55% vs -4.06 ±1.75%, p < 0.001) and fat mass ( -3 ± 1.41% vs -2.17 ± 0.98% p < 0.001) in the first 2 week. Moreover, there was a statistically significant increased in percentage of TBW at week 2 (2.57 ± 4.95% VS 0.24 ± 2.41 P<0.001) in AKI group compared with non-AKI group. Multivariate analysis revealed that low baseline of total body water (OR 5.51 (5.15-10.75), p < 0.01) and increased TBW at week 2 (OR 2.46 (1.49-2.97 , p < 0.01 ) were the strong independent predictors for exertional rhabdomyolysis-induced AKI.

Conclusion

The study demonstrates that lack of adequate exercise before recruitment , low baseline potassium, low baseline TBW and increased TBW in early training period are the additional risk factors for exertional rhabdomyolysis-induced AKI. To our best knowledge this is the first study which explore the body composition change for prediction of exertional rhabdomyolysis induced. Early detection of these parameters should be
implemented for AKI prevention program.