Researchers Create Tool to Predict Risk of Kidney Failure or Death Due To Rhabdomyolysis

Researchers of a new study have created a tool that can be used to predict the chances of kidney failure or death among patients with rhabdomyolysis.

Rhabdomyolysis is an injury caused due to muscle cramps. The condition is characterized by the triad of muscle weakness, myalgias, and dark urine in adults, though all three symptoms may not be visible in children diagnosed with this condition. Myalgias and generalized muscle weakness are common symptoms among children. Rhabdomyolysis has many etiologies and is often multi-factorial in adult patients. Infection and inherited disorders appear to be the most prevalent etiologies in children. Sensitive laboratory markers of myocyte injury include elevated plasma creatine kinase (CK) levels.

Researchers from Brigham and Women's Hospital (BWH) have created a tool that can be used to predict the chances of kidney failure or death among patients with this condition.

"Currently doctors cannot easily predict which patients are most likely to have severe kidney failure or die from rhabdomyolysis," explained Gearoid McMahon, MB, BCh, a clinical fellow in BWH's Department of Medicine and lead author on this study, in a press release. "Using routinely available clinical variables, we have developed a new risk prediction score that doctors can use to help predict a patient's expected outcome and plan for treatment accordingly."

For the study, researchers looked at the data of 2,371 patients admitted between 2000 and 2011 and analyzed variables that are thought to be associated with poor outcomes in this patient population, such as age, gender, and CPK levels. They then created a score from this data predicting the patient's risk of renal failure or death.

"This model may be particularly useful to evaluate and triage patients in the Emergency Department (ED)," said Sushrut Waikar, MD, MPH, director of Renal and Ambulatory Services at BWH and senior author of the study. "By current practice standards, patients with rhabdomyolysis are treated similarly regardless of the underlying cause and overall risk profile. Knowledge of the predicted risk of adverse outcomes may lead clinicians to choose different treatment options such as intravenous fluid administration in the ED followed by discharge with plans for repeat outpatient labs, rather than inpatient hospitalization for observation."

The next step of the research includes testing how well the new tool works and how it can be used to guide physicians into making treatment decisions.

Click here to view an online version of the tool.