Abstract
Introduction
Rhabdomyolysis induced acute kidney injury (AKI) develops due to leakage of the potentially
nephrotoxic intracellular content into the circulation. This study aimed to evaluate
the prevalence and predictive factors of AKI in Kermanshah earthquake victims.
Methods
This cross-sectional study was performed on victims of 2017 Kermanshah earthquake,
Iran, who were admitted in Kermanshah and Tehran Hospitals. Data of the hospitalized
patients were gathered and the prevalence of rhabdomyolysis induced AKI was studied.
In addition, correlations of various clinical and laboratory variables with rhabdomyolysis
induced AKI were assessed.
Results
370 hospitalized patients with the mean age of 39.24 ± 20.32 years were studied (58.6%
female). 10 (2.7% of all admitted) patients were diagnosed with AKI. Time under the
rubble (p < .0001), serum level of creatinine phosphokinase (CPK) (p < .001), lactate dehydrogenase (LDH) (p < .0001), aspartate aminotransferase (AST)
(p = .001) and uric acid (p = .003) were significantly higher in patients with AKI. Area under the ROC curves
of CPK, LDH, AST, and uric acid for predicting the risk of developing AKI were 0.883
(95% CI: 0.816–0.950), 0.865 (95% CI: 0.758–0.972), 0.846 (95% CI: 0.758–0.935), and
0.947 (95% CI: 0.894–0.100), respectively. The best cutoff points for CPK, LDH, AST,
and uric acid in this regard were 1656 IU/L, 839.5 U/L, 46.00 IU/L, and 5.95 mg/dL.
Conclusion
The rate of traumatic rhabdomyolysis induced AKI development was estimated to be 2.7%.
Time under the rubble and serum levels of CPK, LDH, AST, and uric acid were identified
as the most important predictive factors of AKI development.
Keywords
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References
- Outcomes of fasciotomy in patients with crush-induced acute kidney injury after bam earthquake.5(1). 2011: 25
- Practical strategies to reduce morbidity and mortality of natural catastrophes: A retrospective study based on bam earthquake experience.12(4). 2009
- Accuracy of urine dipstick in the detection of patients at risk for crush-induced rhabdomyolysis and acute kidney injury.. 2012; 19: 329-332
- The value of serum creatine kinase in predicting the risk of rhabdomyolysis-induced acute kidney injury: A systematic review and meta-analysis.20(2). 2016: 153-161
- Crush syndrome: saving more lives in disasters: lessons learned from the early-response phase in Haiti.. 2011; 171: 694-696
- Disaster nephrology: a new concept for an old problem.. 2015; 8: 300-309
- Rhabdomyolysis.Am Fam Physician. 2002; 65: 907-912
- Clinical findings in the renal victims of a catastrophic disaster: The Marmara earthquake.17(11). 2002: 1942-1949
- Lessons learned from the Marmara disaster: Time period under the rubble.30(11). 2002: 2443-2449
- Prophylactic fluid therapy in crushed victims of bam earthquake.. 2011; 29: 738-742
- Disaster nephrology: Crush injury and beyond.85(5). 2014: 1049-1057
- Pathogenesis and treatment of rhabdomyolysis.14(2). 2002: 82-87
- Epidemiologic aspects of the bam earthquake in Iran: the nephrologic perspective.. 2006; 47: 428-438
- Early detection of patients at high risk for acute kidney injury during disasters: Development of a scoring system based on the bam earthquake experience.2008
- Crush syndrome and acute kidney injury in the Wenchuan earthquake.. 2011; 70: 1213-1218
- The Marmara earthquake: epidemiological analysis of the victims with nephrological problems.. 2001; 60: 1114-1123
- Wide spectrum of traumatic rhabdomyolysis in earthquake victims.2009: 459-464
- Role of dipstick in detection of haeme pigment due to rhabdomyolysis in victims of bam earthquake.2010
- The role of scoring systems and urine dipstick in prediction of Rhabdomyolysis-induced acute kidney injury a systematic review.. 2016; 10: 101
Article Info
Publication History
Published online: January 24, 2020
Accepted:
January 23,
2020
Received in revised form:
January 18,
2020
Received:
December 17,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
