P0632RISK FACTORS FOR ACUTE KIDNEY INJURE AMONG PATIENTS WITH RHABDOMYOLYSIS

Abstract

Abstract Background and Aims Rhabdomyolysis (RM) is a syndrome characterized by the abruption of the integrity of skeletal muscle cells with subsequent release of intracellular components into extracellular fluid and circulation. Acute kidney injury (AKI) is a life-threatening complication of rhabdomyolysis. The aim of this study was to assess patients at high risk for the occurrence of AKI defined by KDIGO criteria and in-hospital mortality. Method We performed a retrospective study of patients with creatine kinase levels in excess of 1000 U/L, admitted in West China Hospital of Sichuan University from January 2011 to march 2019. The sociodemographic, clinical and laboratory data of the patients were obtained in an electronic medical record database. Univariate and multiple regression analyses were conducted. Results 329 patients were included in our study. The incidence of AKI was 61.4%, the overall mortality was 19.8%, and patients with AKI tend to have higher mortality than those without AKI (24.8% versus 11.8%, P < 0.01). The clinical conditions most frequently associated with rhabdomyolysis were trauma (28.3%), infection (14.6%), bee stings (12.8%), thoracic and abdominal operations (11.2%) and exercise (7.0%). Patients resulted from sepsis, bee stings and acute alcoholism were susceptible to AKI. The risk factors for the occurrence of AKI among rhabdomyolysis patients included age≥60 (OR 3.070), chronic alcoholism (OR 3.256), hypertension (OR 4.252), multiple organ dysfunction syndrome (OR 7.244), elevated white blood cell counts (OR 1.047) and serum phosphorus (OR 5.526). Age≥60 (OR 3.188), multiple organ dysfunction syndrome (OR 2.262), diabetes (OR 2.746) and elevated prothrombin time (OR 1.079) were independent risk factors for in-hospital mortality of rhabdomyolysis patients with AKI. Conclusion AKI is independently associated with mortality in rhabdomyolysis patients. Several risk factors were found to be associated with the occurrence of AKI and in-hospital mortality. The findings aiming to suggest early prevention of AKI should target on patients with high risk and more effective management to improve the quality of medical care.