Factors Associated With Nontraumatic Rhabdomyolysis and Acute Renal Failure of Children in Taiwan Population

Abstract

We evaluated nontrauma causes of rhabdomyolysis and the factors associated with the development of acute renal failure (ARF) of children in Taiwan. We also explored the sex and age characteristics of patients with rhabdomyolysis. A chart review was conducted of patients younger than 17 years who were treated between January 1997 and December 2006 with a final diagnosis of rhabdomyolysis. One hundred seventy-two patients (136 boys and 36 girls) with a mean age of 7.28 years were enrolled. The most common nontrauma causes of rhabdomyolysis were viral myositis (124, 72%), physical exertion (12, 6%), seizure disorder and sepsis (7, 4.1%). Of 172 patients, 15 (8.72%) developed ARF and 5 (3%) received hemodialysis therapy. Several clinical and laboratory factors, such as serum creatine phosphokinase and serum myoglobin, were statistically associated with the development of ARF. The series confirmed our clinical expectation and showed that viral myositis accounted for more than half of the cases. Physical exertion was the second. Seizure disorder and sepsis were the third most frequent causes. These findings are consistent with other reports except seizure disorder. Serum creatine phosphokinase and myoglobin were reliable predictors for the development of ARF. We found that children with rhabdomyolysis due to seizure are at highest risk of developing ARF. Our findings also indicate that the rate of ARF with pediatric rhabdomyolysis is in fact much lower than reported previously (8.7%).