title: The modern spectrum of rhabdomyolysis: drug toxicity revealed by creatine kinase screening.
abstract: 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.
authors.affiliation: Scripps Mercy Hospital, San Diego, CA 92103, USA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Linares
authors.forename: Beatrice A
authors.initials: BA
authors.lastname: Golomb
authors.forename: Joyce A
authors.initials: JA
authors.lastname: Jaojoco
authors.forename: Harminder
authors.initials: H
authors.lastname: Sikand
authors.forename: Paul S
authors.initials: PS
authors.lastname: Phillips
mesh_terms: 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
chemical_list: D015415:Biomarkers; D003402:Creatine Kinase