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. 2021 Oct;34(5):1725-1735.
doi: 10.1007/s40620-020-00950-7. Epub 2021 Jan 5.

Paracetamol use and lowered risk of acute kidney injury in patients with rhabdomyolysis

Maxime Desgrouas  1 , Thierry Boulain  2
Affiliations

Paracetamol use and lowered risk of acute kidney injury in patients with rhabdomyolysis

Maxime Desgrouas et al. J Nephrol. 2021 Oct.

Abstract

Background: Mortality with rhabdomyolysis-associated acute kidney injury can be as high as 80%. Experimental data from mouse models of rhabdomyolysis showed that paracetamol reduces the expected increase in serum creatinine level. We aimed to assess the association between paracetamol use and the need for starting renal replacement therapy (RRT).

Methods: We conducted a propensity score-matched cohort study in Orléans Hospital, France (a 1136-bed, public, university-affiliated and teaching hospital). All patients with serum creatine phosphokinase (CK) level > 5000 IU/L between January 1st, 2008 and December 31st, 2017 were included. A propensity score was calculated for each included patient by using multivariable logistic regression and all available baseline characteristics. The main outcome was the incidence of RRT initiation from day 1 to day 28 in the propensity score-matched cohort between patients exposed and unexposed to paracetamol.

Results: Over the study period, 1065 patients with at least one CK level measurement > 5000 IU/L were included; 40 (3.8%) had at least one RRT session. Among the 343 matched pairs, 10 (2.9%) exposed and 24 (7.0%) unexposed patients underwent RRT before day 28 (P = 0.021). Primary time-to-event analysis showed that exposure to paracetamol was significantly associated with reduced absolute risk of RRT: absolute risk difference = - 3.18% (95% CI - 5.23 to - 1.20, P = 0.001). All secondary analyses showed a significantly reduced absolute risk of RRT in patients exposed to paracetamol.

Conclusion: Our study showed a significant association between paracetamol exposure and reduced incidence of RRT among patients with rhabdomyolysis.

Keywords: Acute renal failure; Oxidative stress; Renal dialysis; Rhabdomyolysis.

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References

    1. Huerta-Alardín AL, Varon J, Marik PE (2004) Bench-to-bedside review: Rhabdomyolysis–an overview for clinicians. Crit Care 9:158–169. https://doi.org/10.1186/cc2978 - DOI - PubMed - PMC
    1. Zutt R, van der Kooi AJ, Linthorst GE et al (2014) Rhabdomyolysis: review of the literature. Neuromuscul Disord 24:651–659. https://doi.org/10.1016/j.nmd.2014.05.005 - DOI - PubMed
    1. Brown CVR, Rhee P, Chan L et al (2004) Preventing renal failure in patients with rhabdomyolysis: do bicarbonate and mannitol make a difference? J Trauma 56:1191–1196. https://doi.org/10.1097/01.TA.0000130761.78627.10 - DOI - PubMed
    1. El-Abdellati E, Eyselbergs M, Sirimsi H et al (2013) An observational study on rhabdomyolysis in the intensive care unit. Exploring its risk factors and main complication: acute kidney injury. Ann Intensive Care 3:8. https://doi.org/10.1186/2110-5820-3-8 - DOI - PubMed - PMC
    1. Safari S, Yousefifard M, Hashemi B et al (2016) The value of serum creatine kinase in predicting the risk of rhabdomyolysis-induced acute kidney injury: a systematic review and meta-analysis. Clin Exp Nephrol 20:153–161. https://doi.org/10.1007/s10157-015-1204-1 - DOI - PubMed

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