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Acute Kidney Injury in Rhabdomyolysis: A 5-Year Children's Hospital Network Study.

Jamie M Pinto1,2, Gregory Ison1, Lora J Kasselman3

  • 1Jersey Shore University Medical Center, 1945 Route 33, Neptune, NJ 07753, USA.

Healthcare (Basel, Switzerland)
|September 14, 2024
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Summary

Rhabdomyolysis, a skeletal muscle injury, can lead to acute kidney injury (AKI) in children. Older age, myoglobinuria, and bicarbonate treatment were linked to AKI in this pediatric study.

Keywords:
acute kidney injurypediatricrhabdomyolysis

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Area of Science:

  • Pediatric Nephrology
  • Muscle Physiology

Background:

  • Rhabdomyolysis is a serious skeletal muscle injury with potential for acute kidney injury (AKI).
  • Understanding risk factors for AKI in pediatric rhabdomyolysis is crucial due to a lack of standardized treatment guidelines.

Purpose of the Study:

  • To investigate factors associated with AKI in pediatric patients diagnosed with rhabdomyolysis.
  • To explore the management strategies employed for pediatric rhabdomyolysis cases.

Main Methods:

  • Retrospective review of medical records from a children's hospital network over a 5-year period.
  • Analysis of 112 pediatric patients meeting inclusion criteria, comparing those with and without AKI.

Main Results:

  • AKI incidence was 7.1% (n=8), exclusively in patients with exertional rhabdomyolysis.
  • Patients with AKI were significantly older (mean age 17 vs 13.3 years) and more likely to have myoglobinuria and receive intravenous bicarbonate.
  • Older age (OR=1.44), myoglobinuria (OR=22.98), and intravenous bicarbonate (OR=16.02) were associated with AKI.

Conclusions:

  • Acute kidney injury is uncommon in pediatric rhabdomyolysis but associated with older age, myoglobinuria, and bicarbonate administration.
  • Further large-scale prospective studies are necessary to elucidate AKI risk factors and optimize treatment protocols for pediatric rhabdomyolysis.