Rhabdomyolysis-associated acute kidney injury: clinical characteristics and intensive care unit transfer analysis.

Background: Information on rhabdomyolysis-associated acute kidney injury (AKI) in the emergency department or general ward is limited.

Aim: To assess the risk factors, outcomes and clinical correlates with intensive care unit (ICU) transfer of patients with rhabdomyolysis-associated AKI.

Methods: Patients with rhabdomyolysis were divided into the rhabdomyolysis-associated AKI group and the rhabdomyolysis without AKI group. Inhospital outcomes, including ICU transfer, mortality, length of stay, daily cost and renal recovery were analysed. Multivariate regression analysis was performed to identify the association between rhabdomyolysis-associated AKI and ICU transfer.

Results: Among 149 patients with rhabdomyolysis, 68 (45.6%) developed AKI. Age and urine protein were important risk factors for incidence of rhabdomyolysis-associated AKI. Patients with rhabdomyolysis-associated AKI had higher levels of undergoing dialysis (19.1% vs 2.5%; P < 0.01), all-cause mortality (13.2% vs 1.2%; P < 0.01), cost of hospitalisation (10.8 1000 yuan, IQR (5.5, 3.5) vs 5.9 1000 yuan, IQR 5.9 (3.6, 9.9); P = 0.03), as well as longer length of hospital stay (8.0 days (5.0, 14.0)) versus (6.0 days (4.0, 11.0); P = 0.02). Additionally, the percentage of patients with AKI who transferred to ICU was higher than patients without AKI (33.8% vs 12.3%; P < 0.002) and rhabdomyolysis-associated AKI was an independent risk factor for ICU transfer (adjusted odds ratio = 2.58; 95% confidence interval, 1.12-6.8, P = 0.03).

Conclusion: Rhabdomyolysis-associated AKI was common in the emergency department or general ward and led to more severe outcomes. It was also associated with an increased risk of ICU transfer.