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Kidney Week

Abstract: FR-PO036

Rhabdomyolysis in Young Adults

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Author

  • Khan, Asif, Staten Island University Hospital, Brooklyn, New York, United States
Background

Rhabdomyolysis is a clinical entity that directly causes AKI and is associated with a subsequent increase in patient mortality. The primary means of diagnosis is made via clinical suspicion from patient history, clinician knowledge of risk factors, and laboratory testing such as the utilization of CK for diagnosis. However, patient risk factors are dependent upon age and if not adequately assessed can lead to a missed diagnosis. Furthermore, other serum markers can potentially be used to aid in prognosis.

Our study seeks to describe the risk factors for rhabdomyolysis in adults younger than 50 years. It explores etiology and demographic characteristics in relation to severity of illness, length of stay, and short-term outcomes. Finally, it indicates the accuracy of NLR as a prognostic tool.

Methods

A single-center retrospective cohort study was completed to evaluate patients admitted to hospital for primary diagnosis of rhabdomyolysis. NLR was calculated and compared to CK levels to determine association and assistance with diagnosis.

Results

331 Rhabdomyolysis patients were included in the study. Data were stratified into 3 groups based on CK level (1500-5000, 5000-50000, >50000 IU/L). 34.83% of cases were due to illicit drugs with 80% attributed to Heroin and/or Cocaine use. Drug use was also the major etiology (28.1%) when CK level was 1500 - 50000 IU/L. The second leading cause of Rhabdomyolysis was exercise-induced (16.47%). Exercise was the major etiology (40%) in subjects with CK levels above 50,000 IU/L. Subjects with exercise-induced rhabdomyolysis had a median serum CK (8,840) more than twice the median for the entire group (4,012), but their median length of stay (2 days) was half the entire group’s median (4 days). On the other hand, there was a statistically significant positive correlation between the NLR (4.79, 5.61, and 10.19 respectively) and the length of stay (4.58, 6.59, 7.8 days respectively) (p= <0.001; Spearman correlation 0.22).

Conclusion

Illicit drug use was the major cause of rhabdomyolysis in adults < 50 years old. Exercise was the second leading cause of rhabdomyolysis with a higher median serum CK but lower than the median length of stay indicating that CK is not an accurate prognostic indicator. NLR has a positive correlation to serum CK and the total length of stay suggesting it is an important prognostic biomarker. Larger studies in different patient populations are warranted to validate findings.