Relationship between elevated creatine phosphokinase and the clinical spectrum of rhabdomyolysis.
The incidence, causes and complications of severe rhabdomyolysis (creatine phosphokinase (CK) > or = 5000 U/l) were studied during a 7-year study period in a large university hospital population. This condition was present in 0.074% of all admitted patients. The mortality in the study group (n = 93) was 32% and the incidence of acute renal failure (ARF) 51%. Ischaemia was the most frequent cause, and drugs, alcohol and/or coma were the second most common cause of severe rhabdomyolysis. Patients with rhabdomyolysis due to ischaemia were older, had ARF more often, and also had the highest mortality. Hyperkalaemia (potassium > or = 5.5 mmol/l) occurred in 13% of the patients, and all of them had or developed an impaired renal function. Hypocalcaemia (calcium < or = 2.00 mmol/l) was found in 41%. The incidence of ARF and electrolyte disturbances was higher in patients with CK levels exceeding 15,000 U/l. Mortality was significantly higher in patients with ARF. Plasma concentrations of potassium and calcium correlated better with the severity of renal failure than with the maximal height of plasma CK.
Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
J
J
Veenstra
W M
WM
Smit
R T
RT
Krediet
L
L
Arisz
D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D012206:Rhabdomyolysis / Q000097:blood / Q000150:complications* / Q000209:etiology / Q000401:mortality
D003402:Creatine Kinase; D011188:Potassium; D002118:Calcium