Background
Methods
Information sources
Search approach
Data collection
Results
Article | Type of study | Type of patients | RM definition | Etiologies | Risk factors | Patients with RM | Comments |
---|---|---|---|---|---|---|---|
Mannix et al. 2006 [16] | RS | Pediatric patients in the ED | CK level >1000 IU/L | Viral myositis, trauma, connective tissue disease | NA | RM = 191 | Most common reported symptoms were muscle pain and fever. AKI developed in only nine patients |
Lagandre et al. 2006 [17] | POS | 49 bariatric post-operative patients | CK level >1000 IU/L | NA | Surgical time >4 h, diabetes, BMI >40 kg/m2
| RM = 13 | Type of surgeries performed were gastric banding or bypass |
De Oliveira et al. 2009 [18] | POS | 22 bariatric post-operative patients | An increase >5× the upper limit of the normal CK level | NA | Prolonged surgical duration | RM = 17 | Clinical neuromuscular symptoms occurred in 45 % of patients |
Linares et al. 2009 [19] | RS | Hospitalized patients | CK levels >5000 IU/L | Recreational drugs and alcohol, trauma, compression, shock and statin use | NA | RM = 106 | The authors suggest that RM should be defined using CK levels above 10–25 times the upper limit of normal. AKI developed in 52 patients |
Youssef et al. 2010 [20] | POS | 23 bariatric post-operative patients | Post-operative CK levels >1000 IU/L | NA | BMI >56 kg/m2
| RM = 7 | Factors such as sex, age, and length of surgery were not good predictors of RM |
Alpers et al. 2010 [21] | RS | Patients in military training | Muscle pain, weakness, or swelling over <7 days with a CK >5× the upper limit of normal | Exertional RM | NA | RM = 177 | Authors comment that exertional RM is associated with lower incidence of AKI |
Bache et al. 2011 [22] | RS | 76 burn patients in the ICU | “Late-onset” RM: CK >1000 U/L, 1 week or more after burn episode | NA | Sepsis, nephrotoxic drugs, hypokalemia | “Late-onset” RM = 7 | Authors suggest measuring CK in all patients with the risk factors described in burn patients to initiate prompt treatment |
Oshima 2011 [23] | RS | Cases of drug-related RM | NA | Drug use | <10 year olds, weight less than 50 kg | RM = 8610 | Lipid lowering drugs were most frequently reported as the associated drugs |
Herraez Garcia et al. 2012 [24] | RS | Adult hospitalized patients | CK level of 5× upper limit (975 UI/L) | Trauma, sepsis, immobility | Elder patients and male sex | RM = 449 | No relationship was found between CK levels and AKI development or mortality |
El-Abdellati et al. 2013 [25] | RS | 1769 ICU patients | CK level >1000 U/L | Prolonged surgery, trauma, ischemia, infections | Surgical duration >6 h, resuscitation, compartment syndrome | RM = 342 | The authors found a correlation between CK levels and the development of AKI |
Rodriguez et al. 2013 [26] | RS | Acute-care hospital patients | Severe RM: >5000 IU/L | Immobilization, illicit drug abuse, infections, trauma | NA | Severe RM = 126 | More than half of the patients developed AKI. Variables associated with poor outcome were hypoalbuminemia, metabolic acidosis, and decreased prothrombin time |
Chen et al. 2013 [27] | RS | Pediatric patients in the ED | CK levels >1000 IU/ | Infection, trauma, exercise | NA | RM = 37 | Common symptoms were muscle pain and weakness. Dark urine reported in 5.4 % of patients |
Talving et al. 2013 [28] | RS | Pediatric trauma patients | NA | Trauma | NA | RM = 521 | AKI occurred in 70 patients. The authors concluded that a CK level ≥3000 was an independent risk factor for developing AKI |
Grunau et al. 2014 [29] | RS | Patients in the ED | CK levels >1000 U/L | Illicit drug use, infections, trauma | NA | RM = 400 | AKI developed in 151 patients; 18 patients required hemodialysis |
van Staa et al. 2014 [30] | RS | 641,703 statin users | CK levels 10× the upper limit of normal | Statin drug use | Drug–drug interaction | Reported with RM = 59 CK >10× = 182 | The incidence of RM in this cohort of statin users was very low |
Pariser et al. 2015 [31] | RS | 1,016,074 patients with a major urologic surgery | NA | NA | Diabetes, chronic kidney disease, obesity, bleeding, age and male sex | RM = 870 | Surgeries associated with RM were nephrectomy (radical or partial) and radical cystectomy |
Article | Type of study | Population | IV fluid | Bicarbonate/mannitol | Rate of AKI and need for RRT |
---|---|---|---|---|---|
Altintepe et al. 2007 [55] | CS |
N = 9 | Fluid type used 5 % dextrose and 0.45 NS. 4–8 L of IV fluid daily | 40 mEq NaHCO3 and 50 mL of 20 % mannitol mixed with 1 L of IV fluid (0.45 % NaCl and 5 % dextrose) They targeted a urine pH above or equal 6.5 | 2 patients (28.6 %) developed AKI Patients received hemodialysis due to hyperkalemia |
Cho et al. 2007 [56] | PS |
N = 28 | Fluid therapy consisted of lactated Ringer’s solution (13 patients) versus NS (15 patients) (the authors concluded that LR was more useful than NS) IV fluid rate 400 mL/h | Bicarbonate was used to achieve urine pH ≥6.5 in the patients with NS IV fluid | No patient developed AKI |
Talaie et al. 2008 [51] | RS |
N = 156 | Fluid therapy given 1–8 L in the first 24 h (mean IV fluid 3.2 L/24 h) | Bicarbonate was given to 115 patients | 30 patients (28.6 %) developed AKI |
Zepeda-Orozco et al. 2008 [57] | RS |
N = 28 | 36 % of the patients received saline infusion (20 mL/kg) in the first 24 h | 79 % of patients received sodium bicarbonate IV fluid | 11 patients (39.2) developed AKI 7 patients with CK levels >5000 U/L required RRT |
Sanadgol et al. 2009 [58] | CS |
N = 31 | 0.45 % NS | 15 mEqL NaHC03 mixed with IV fluid Alkaline IV solution 3–5× more than maintenance rate was used | 8 patients (25.8 %) developed AKI |
Iraj et al. 2011 [34] | PS |
N = 638 | Authors recommend >6 L/day in severe RM and ≥3 L/day IV fluid in moderate RM to decrease the incidence of AKI | NA | 134 patients (21 %) developed AKI 110 patients required RRT |
Data synthesis
Definition
Epidemiology and etiology
Type | Cause | Examples |
---|---|---|
Acquired | Trauma | “Crush syndrome” |
Exertion | Intense muscle activity, energy depletion, electrolyte imbalance | |
Ischemia | Immobilization, compression, thrombosis | |
Illicit drugs | Cocaine, heroin, LSD | |
Alcohol | Acute or chronic consumption | |
Drugs | Dose-dependent, multiple interactions | |
Infections | Bacterial, viral, parasitic | |
Extreme temperatures | Hyperthermia, hypothermia, neuroleptic malignant syndrome | |
Endocrinopathies | Hyper/hypo-thyroidism, diabetic complications | |
Toxins | Spider bites, wasp stings, snake venom | |
Inherited | Metabolic myopathies | Glycogen storage, fatty acid, mitochondrial disorders |
Structural myopathies | Dystrophinopathy, dysferlinopathy | |
Channel related gene mutations | RYR1 gene mutation, SCN4A gene mutation | |
Others | Lipin-1 gene mutation, sickle-cell disease, “benign exertional rhabdomyolysis” |