The modern spectrum of rhabdomyolysis: drug toxicity revealed by creatine kinase screening.

Abstract

PURPOSE:

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: Leslie A Linares, Beatrice A Golomb, Joyce A Jaojoco, Harminder Sikand, Paul S Phillips
• Journal: Current drug safety (Curr Drug Saf) Vol. 4 Issue 3 Pg. 181-7 (Sep 2009) ISSN: 2212-3911 [Electronic] United Arab Emirates
• PMID: 19534642 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Biomarkers
• Creatine Kinase

Topics

• Acute Kidney Injury (chemically induced, diagnosis)
• Adult
• Biomarkers (blood)
• California
• Clinical Enzyme Tests
• Creatine Kinase (blood)
• Female
• Humans
• Inpatients
• Male
• Middle Aged
• Predictive Value of Tests
• Retrospective Studies
• Rhabdomyolysis (chemically induced, diagnosis)
• Risk Factors
• Up-Regulation