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Kidney Week

Abstract: FR-PO016

The Incidence, Risk Factors, and Clinical Outcomes of Rhabdomyolysis Associated with Fenoverine Prescription: A Retrospective Study in South Korea (1999–2014)

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Cho, Junhyeong, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)
  • Na, Jeonggu, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)
  • Bae, Eunjin, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)
  • Lee, Tae won, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)
  • Jang, Ha nee, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)
  • Cho, Hyun Seop, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)
  • Chang, Se-Ho, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, Jinju, Korea (the Republic of)
  • Park, Dong Jun, Gyeongsang National University Changwon Hospital and Gyeongsang National University College of Medicine, Changwon, Korea (the Republic of)
Background

Fenoverine is a spasmolytic drug that has been used to treat abdominal pain. Although sporadic case reports of rhabdomyolysis associated with fenoverine have been published, there are no studies evaluating the correlation of this drug with rhabdomyolysis.

Methods

We retrospectively reviewed the medical records of 22 patients admitted with rhabdomyolysis associated with fenoverine from January 1999 to December 2014, while excluding other well-known risk factors of rhabdomyolysis. This period was subdivided into two periods, January 1999–December 2007 and January 2008–December 2014. We analyzed the clinical and laboratory characteristics, and the prognosis of fenoverine associated with rhabdomyolysis for these times.

Results

The incidence of rhabdomyolysis associated with fenoverine was 0.27% during the total period (22/8257), 0.34% in the first period (18/5298), and 0.14% in the second period (4/2959) (p < 0.001). Rhabdomyolysis occurred in 22 liver cirrhosis (LC) patients (2.03%), whereas only 3 cases (0.04%) occurred in non-LC patients (p < 0.001). Drug duration, total dose, muscle enzymes, and clinical characteristics were not different between the LC and non-LC groups. Acute renal failure (ARF) occurred in 5 patients in the LC group and 2 patients in the non-LC group (p = 0.227). Severity of hepatic derangement according to the Child-Pugh classification was not different between the ARF group and non-ARF group (p = 0.227). Four patients died, having complications of oliguric ARF (p = 0.005) and underlying severe LC (p = 0.017). Higher serum lactate dehydrogenase, blood urea nitrogen, creatinine, and potassium levels but lower serum sodium levels were found in the group that died (p = 0.001).

Conclusion

Physicians should not use fenoverine in patients with LC because of a high incidence of rhabdomyolysis and its poor prognosis.