J Korean Soc Emerg Med.  2001 Sep;12(3):222-229.

Predicting Factors for Acute Renal Failure Induced by Rhabdomyolysis at the Early Stage of Multiple Trauma

• Moon JB
• Lee KH
• Hwang SO
• Lee JW
• Han BG
• Choi SO
• Kang SJ

Abstract

BACKGROUND: Acute renal failure(ARF) is a serious complication of rhabdomyolysis after multiple trauma, and may increase morbidity and mortality. The aim of this study was to elucidate predicting factors for the development of ARF induced by rhabdomyolysis at an early stage of multiple trauma.
METHODS
This prospective, observational study was conducted at the emergency department of a level I trauma center. Patients with acute multiple trauma, whose plasma levels of creatine phosphokinase(CPK) were higher than 1,000 IU, were included in this study. We excluded patients with any history of myocardial infarction, stroke, underlying renal disease, and/or infectious disease. We collected clinical and laboratory data including age, heart rate, mean arterial blood pressure, injury severity score, serum myoglobin, lactic dehydrogenase, creatine phosphokinase, and base excess. Collected data were compared between patients who had ARF and patients who did not have ARF.
RESULTS
Eighty-eight patients were enrolled in this study. Eighteen patients(20.5%) developed ARF. The injury severity score(ISS)(p=0.001), the base excess(p<0.001), CPK(p=0.003), and myoglobin(p<0.001) were higher in patients with ARF than in patient without ARF. Logistic regression analysis revealed that early predictors for ARF were high ISS, high base excess, high CPK, and high myoglobin.
CONCLUSION
We could identify early predicting factors for acute renal failure induced by rhabdomyolysis, these factors included ISS, serum CPK and myoglobin, and base excess in the arterial blood gas analysis performed at the emergency department.

Keyword

Rhabdomyolysis; Acute renal failure; Multiple trauma

MeSH Terms

Acute Kidney Injury*
Arterial Pressure
Blood Gas Analysis
Communicable Diseases
Creatine
Creatine Kinase
Emergency Service, Hospital
Heart Rate
Humans
Injury Severity Score
Logistic Models
Mortality
Multiple Trauma*
Myocardial Infarction
Myoglobin
Observational Study
Oxidoreductases
Plasma
Prospective Studies
Rhabdomyolysis*
Stroke
Trauma Centers
Creatine
Creatine Kinase
Myoglobin
Oxidoreductases