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

Sukdong Yoo, Min Hyun Cho, Hee Sun Baek, Ji Yeon Song, Hye Sun Lee, Eun Mi Yang, Kee Hwan Yoo, Su Jin Kim, Jae Il Shin, Keum Hwa Lee, Tae Sun Ha, Kyung Mi Jang, Jung Won Lee, Kee Hyuck Kim, Heeyeon Cho, Mee Jeong Lee, Jin Soon Suh, Kyoung Hee Han, Hye Sun Hyun, Il Soo HaHae Il Cheong, Hee Gyung Kang, Mee Kyung Namgoong, Hye Kyung Cho, Jae Hyuk Oh, Sang Taek Lee, Kyo Sun Kim, Joo Hoon Lee, Young Seo Park, Seong Heon Kim

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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.

Original languageEnglish
Pages (from-to)673-686
Number of pages14
JournalKidney Research and Clinical Practice
Volume40
Issue number4
DOIs
StatePublished - Dec 2021

Bibliographical note

Publisher Copyright:
© 2021 by The Korean Society of Nephrology.

Keywords

  • Creatine kinase
  • Etiology
  • Muscles
  • Renal insufficiency

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