Clinical and Epidemiological Characteristics of Rhabdomyolysis: A Retrospective Study

Abstract

Background: Rhabdomyolysis (RM) refers to a clinical syndrome in which muscle cells are damaged by various causes and the clinical manifestations are mainly muscle pain, weakness, and dark urine. Acute kidney injury (AKI) is a serious complication of RM with complex mechanisms and high mortality. Therefore, understanding the pathogenesis and clinical manifestations, early diagnosis and treatment of RM are crucial to improve its prognosis.

Method: Analysis of medical records of RM patients admitted to Tianjin Medical University General Hospital from October 2019 to October 2022. Statistical software SPSS 25.0 was used to analyze the data. The risk factors of RM-complicated AKI were analyzed by logistic regression. The receiver operating characteristic (ROC) curve was plotted, the area under the curve (AUC) was calculated, and the optimal cutoff value was determined by the Youden index. P < 0.05 indicates a statistically significant difference between the groups.

Result: Among the 71 patients, the median age of the patients was 53.0 (30.0, 71.0) years and was 2.5 times higher in men than in women. Infection was the most common etiology. History of alcohol consumption, CK, and creatinine were independent influencing factors for AKI due to RM. Logistic regression analysis showed that CK combined with creatinine had a better predictive value than the single index.

Conclusion: Our study revealed the clinical and laboratory characteristics of RM in the population attending the Tianjin Medical University General Hospital in the last three years, which is a reference for future multicenter, prospective studies.

Figure 1

Flow diagram.

Figure 2

Etiology of rhabdomyolysis: (a) the proportion of single cause and multiple cause; (b) the number of people in each cause; (c) age distribution of etiology.

Figure 3

Receiver operating characteristic (ROC) curve analysis.

Figure 4

Pathophysiology of rhabdomyolysis-included acute kidney injury. MB: myoglobin; CO: carbon monoxide; HO-1: heme oxygenase-1; Fe²⁺: ferrous iron; Fe³⁺: ferric iron; H₂O₂: hydrogen peroxide; OH⁻: hydroxyl anion; OH: hydroxyl radical; ET: endothelin; TXA2: thromboxane A2; TNF-α: tumor necrosis factor α; NO: nitric oxide; RAAS: renin-angiotensin-aldosterone system; RBF: renal blood flow; TC: tubular cell; THP: Tamm–Horsfall protein.