The modern spectrum of rhabdomyolysis: drug toxicity revealed by creatine kinase screening.
OBJECTIVE
This study describes the current etiologies, demographic characteristics, incidence of acute renal insufficiency and correlation between peak creatine kinase (CK) and peak creatinine in hospitalized patients with rhabdomyolysis.


METHODS
A retrospective chart review of patients with creatine kinase (CK) values greater than 5000 IU/L during a nine month period identified 106 cases of rhabdomyolysis.


RESULTS
The most common contributing etiologies were recreational drug and/or alcohol use in 28%, trauma in 23%, compression in 19%, shock in 17%, statin-use in 13%, seizure in 8% and quetiapine-use in 8%. 37% of cases involved multiple etiologies. Renal insufficiency occurred in 49% of cases and modestly but significantly correlated with CK (R(2) = 0.41, p < 0.0001). Myoglobinuria and a pre-renal state were associated with renal insufficiency in 49% and 52% of cases, respectively.


CONCLUSIONS
Rhabdomyolysis should be defined with CK values exceeding 10-25 times the upper limit of normal irrespective of renal function. Using a laboratory marker such as CK can aid diagnosis of rhabdomyolysis and identify adverse drug events.
Linares
Leslie A
LA
Scripps Mercy Hospital, San Diego, CA 92103, USA.
Golomb
Beatrice A
BA
Jaojoco
Joyce A
JA
Sikand
Harminder
H
Phillips
Paul S
PS
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002140:California; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000175:diagnosis*; D012307:Risk Factors; D015854:Up-Regulation
D015415:Biomarkers; D003402:Creatine Kinase