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KMID : 1102220210400040673
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Kidney Research and Clinical Practice
2021 Volume.40 No. 4 p.673 ~ p.686
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Characteristics of pediatric rhabdomyolysis and the associated risk factors for acute kidney injury: a retrospective multicenter study in Korea
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Yoo Suk-Dong
Cho Min-Hyun
Baek Hee-Sun
Song Ji-Yeon
Lee Hye-Sun
Yang Eun-Mi
Yoo Kee-Hwan
Kim Su-Jin
Shin Jae-Il
Lee Keum-Hwa
Ha Tae-Sun
Jang Kyung-Mi
Lee Jung-Won
Kim Kee-Hyuck
Cho Hee-Yeon
Lee Mee-Jeong
Suh Jin-Soon
Han Kyoung-Hee
Hyun Hye-Sun
Ha Il-Soo
Cheong Hae-Il
Kang Hee-Gyung
Namgoong Mee-Kyung
Cho Hye-Kyung
Oh Jae-Hyuk
Lee Sang-Taek
Kim Kyo-Sun
Lee Joo-Hoon
Park Young-Seo
Kim Seong-Heon
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Abstract
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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.
Conclusions: 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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KEYWORD
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Creatine kinase, Etiology, Muscles, Renal insufficiency
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