Use of RIFLE Criteria to Predict the Severity and Prognosis of Acute Kidney Injury in Emergency Department Patients with Rhabdomyolysis

Delaney, Kathleen; Givens, Melissa L.; Vohra, Rais

doi:10.1016/j.jemermed.2011.03.008

Cited by 26 publications

(22 citation statements)

References 31 publications

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“…Acute kidney injury (AKI) 2 and need for hemodialysis are potential complications of rhabdomyolysis in emergency department (ED) patients; however, there are little data on the true incidence or course of disease. Published estimates of renal impairment secondary to rhabdomyolysis vary from 16% to 59%, [3][4][5][6][7][8] but there is wide heterogeneity in the definitions used and methodologies of these studies. In particular, most chart reviews rely upon a subjective discharge code of "rhabdomyoloysis," 3,4,6 rather than a strict laboratory definition.…”

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confidence: 99%

“…Published estimates of renal impairment secondary to rhabdomyolysis vary from 16% to 59%, [3][4][5][6][7][8] but there is wide heterogeneity in the definitions used and methodologies of these studies. In particular, most chart reviews rely upon a subjective discharge code of "rhabdomyoloysis," 3,4,6 rather than a strict laboratory definition. Patients identified in this manner typically have severely elevated CK levels, often greater than 30,000 units, 5 and admission to hospital has been the standard of care.…”

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confidence: 99%

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Characteristics and Thirty‐day Outcomes of Emergency Department Patients With Elevated Creatine Kinase

Grunau

Pourvali

Wiens

et al. 2014

Academic Emergency Medicine

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Objectives: Rhabdomyolysis, as defined by an elevation in creatine kinase (CK), may lead to hemodialysis and death in emergency department (ED) patients, but the patient characteristics, associated conditions, and 30-day outcomes of patients with CK values over 1,000 U/L have not been described. Methods:All consecutive ED patients with serum CK values over 1,000 U/L between January 1, 2006, and December 31, 2008, were retrospectively identified from two urban hospitals. Patient characteristics, ED treatment, and ED discharge diagnoses were determined by medical record review. Provincial databases were linked to identify patients who died or were treated with hemodialysis within 30 days. The primary outcome was the combined occurrence of death or need for hemodialysis within 30 days. Secondary outcomes included the incidence of acute kidney injury (AKI) and the proportion of patients with initial estimated glomerular filtration rates (eGFR) > 60 mL/min/1.73 m 2 who died or required hemodialysis.Results: Four-hundred patients were identified, the median age was 50 years (interquartile range [IQR] = 35 to 69 years), and 77% were male, with 35% of patients discharged home from the ED. The most common ED discharge diagnoses were related to recreational drug use, infections, and traumatic or musculoskeletal complaints. Within 30 days, 32 (8.0%, 95% confidence interval [CI] = 5.3% to 11%) experienced primary outcomes, with 18 (4.5%, 95% CI = 2.55% to 6.5%) requiring hemodialysis and 21 deaths (5.3%, 95% CI = 3.1% to 7.4%). AKI occurred in 151 patients (38%, 95% CI = 33% to 43%). Of the 257 patients (64%) with initial eGFRs > 60 mL/min/1.73 m 2 , none required hemodialysis. Conclusions:In ED patients with initial CK > 1,000 U/L, the incidence of death or hemodialysis was 8% within 30 days. Patients with initial eGFRs > 60 mL/min/1.73 m 2 appear to be at a low risk of these outcomes from rhabdomyolysis.ACADEMIC EMERGENCY MEDICINE 2014;21:631-636

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Characteristics and Thirty‐day Outcomes of Emergency Department Patients With Elevated Creatine Kinase

Grunau

Pourvali

Wiens

et al. 2014

Academic Emergency Medicine

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“…AKI is a serious and often life-threatening complication of rhabdomyolysis and requires immediate diagnosis and emergency treatment (9,33,34). AKI is believed to be due to decreased extracellular volume, which results in renal vasoconstriction.…”

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confidence: 99%

“…Medical Science and Discovery, 2016; 3(1): [28][29][30][31][32][33][34] rhabdomyolysis-induced AKI is higher in patients with CK levels at admission more than 5000 IU/L (16).…”

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Admission Characteristics and Outcomes of ED Patients With Rhabdomyolysis

Golcuk

Ozsarac

et al. 2016

Med Sci and Discov

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“…Paralelamente este factor inhibe la 25-hidroxivitamina D, disminuyendo por ende los niveles de vitamina D. Parece que el FGF-23 está elevado en este tipo de falla renal (a diferencia de otros tipos de lesiones), independientemente de la tasa de filtración glomerular (60).…”

Section: Nuevos Marcadores De Falla Renal Y Rabdomiolisis Factor De Cunclassified

Insuficiencia renal aguda inducida por rabdomiolisis

Nieto-Ríos

Vega-Miranda

Higuita

2016

iatreia

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RESUMENLa insuficiencia renal aguda (IRA) es una causa frecuente de morbilidad y mortalidad en los servicios de urgencias, hospitalización y cuidado crítico, siendo la rabdomiolisis responsable del 15 % de los casos en los centros hospitalarios de alta complejidad. La rabdomiolisis consiste en daño muscular con necrosis y liberación a la circulación de componentes intracelulares, y puede tener múltiples causas. El daño renal por rabdomiolisis es multifactorial e incluye obstrucción tubular, vasoconstricción y daño oxidativo. El tratamiento principal de la IRA por rabdomiolisis es la hidratación, forzar la diuresis y evitar los fármacos nefrotóxicos. Cuando el daño es lo suficientemente grave para causar uremia, acidosis metabólica, hiperpotasemia y sobrecarga de volumen se debe recurrir a la terapia de reemplazo renal. Aunque la regla es que se recupere la función renal, estos pacientes tienen mayor riesgo futuro de desarrollar enfermedad renal crónica. PALABRAS CLAVEInsuficiencia Renal Aguda; Mioglobina; Músculo Esquelético; Necrosis; Rabdomiolisis SUMMARY Acute renal failure due to rhabdomyolyisisAcute renal failure is a frequent cause of morbidity and mortality in emergency, hospitalization and critical care services. In 15 % of cases it is due to rhabdomyolysis, in which there is breakdown of skeletal muscle with massive necrosis and leakage of muscle cell contents into the circulation. It has many different etiologies. The rhabdomyolysis-induced acute kidney injury results from the combination of several mechanisms, including tubular obstruction, vasoconstriction and oxidative stress. The most important therapeutic measures are: Aggressive repletion of fluids, forced diuresis and avoidance of exposure to nephrotoxic substances. In cases of

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Use of RIFLE Criteria to Predict the Severity and Prognosis of Acute Kidney Injury in Emergency Department Patients with Rhabdomyolysis

Cited by 26 publications

References 31 publications

Characteristics and Thirty‐day Outcomes of Emergency Department Patients With Elevated Creatine Kinase

Characteristics and Thirty‐day Outcomes of Emergency Department Patients With Elevated Creatine Kinase

Admission Characteristics and Outcomes of ED Patients With Rhabdomyolysis

Insuficiencia renal aguda inducida por rabdomiolisis

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