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Characteristics of pediatric rhabdomyolysis and the associated risk factors for acute kidney injury: a retrospective multicenter study in Korea

Authors
Yoo, SukdongCho, Min HyunBaek, Hee SunSong, Ji YeonLee, Hye SunYang, Eun MiYoo, Kee HwanKim, Su JinShin, Jae IlLee, Keum HwaHa, Tae-SunJang, Kyung MiLee, Jung WonKim, Kee HyuckCho, HeeyeonLee, Mee JeongSuh, Jin-SoonHan, Kyoung HeeHyun, Hye SunHa, Il-SooCheong, Hae IlKang, Hee GyungNamgoong, Mee KyungCho, Hye-KyungOh, Jae-HyukLee, Sang TaekKim, Kyo SunLee, Joo HoonPark, Young SeoKim, Seong Heon
Issue Date
12월-2021
Publisher
KOREAN SOC NEPHROLOGY
Keywords
Creatine kinase; Etiology; Muscles; Renal insufficiency
Citation
KIDNEY RESEARCH AND CLINICAL PRACTICE, v.40, no.4, pp.673 - 686
Indexed
SCIE
SCOPUS
KCI
Journal Title
KIDNEY RESEARCH AND CLINICAL PRACTICE
Volume
40
Number
4
Start Page
673
End Page
686
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/136669
DOI
10.23876/j.krcp.21.051
ISSN
2211-9132
Abstract
Background: The clinical features of pediatric rhabdomyolysis differ from those of the adults with rhabdomyolysis; however, multicenter studies are lacking. This study aimed to investigate the characteristics of pediatric rhabdomyolysis and reveal the risk factors for acute kidney injury (AKI) in such cases. Methods: This retrospective study analyzed the medical records of children and adolescents diagnosed with rhabdomyolysis at 23 hospitals in South Korea between January 2007 and December 2016. Results: Among 880 patients, those aged 3 to 5 years old composed the largest subgroup (19.4%), and all age subgroups were predominantly male. The incidence of AKI was 11.3%. Neurological disorders (53.6%) and infection (39.0%) were the most common underlying disorder and cause of rhabdomyolysis, respectively. The median age at diagnosis in the AKI subgroup was older than that in the non-AKI subgroup (12.2 years vs. 8.0 years). There were no significant differences in body mass index, myalgia, dark-colored urine, or the number of causal factors between the two AKI-status subgroups. The multivariate logistic regression model indicated that the following factors were independently associated with AKI: multiorgan failure, presence of an underlying disorder, strong positive urine occult blood, increased aspartate aminotransferase and uric acid levels, and reduced calcium levels. Conclusion: Our study revealed characteristic clinical and laboratory features of rhabdomyolysis in a Korean pediatric population and highlighted the risk factors for AKI in these cases. Our findings will contribute to a greater understanding of pediatric rhabdomyolysis and may enable early intervention against rhabdomyolysis-induced AKI.
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