NSAIDs, dehydration pre-hospitalization may be linked to higher AKI risk in some patients
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Key takeaways:
- The overall occurrence of AKI was 8.5% in patients with exertional rhabdomyolysis.
- No patients developed chronic kidney disease.
Dehydration or use of NSAIDs before hospital admission may be linked to a higher risk of AKI in patients with exertional rhabdomyolysis, researchers found in a published study.
Studies show “exertional rhabdomyolysis (ERM), caused by strenuous physical exertion, had a 10-fold increase in incidence in the U.S. from 2000 to 2019 for unknown reasons, with incidence rates from [one] to 31.8 per 100,000 population across different populations,” Amir H. Sabouri, MD, PhD, of the Permanente Medical Group neurology division in Walnut Creek, California, wrote with colleagues. “Concurrently, research on the outcomes of ERM, both AKI and [chronic kidney disease] CKD, and associated risk factors remains scarce.”
Researchers conducted a retrospective cohort study involving a diverse group of 200 adults with ERM who were hospitalized at Kaiser Permanente Northern California between 2009 and 2019. Mean age of patients was 30.5 years, and patients were identified through electronic screening for all-cause rhabdomyolysis admissions and confirmed through medical record reviews.
AKI and CKD diagnosis was based on Kidney Disease: Improving Global Outcomes criteria. Main outcomes were AKI and CKD development, as well as additional co-factors to AKI. Data analysis was performed from 2023 to 2024.
The overall occurrence of AKI was 8.5%, according to the findings. No patients developed CKD, 0.5% developed compartment syndrome and none died. Additionally, researchers found no association between serum creatine kinase levels and the development of AKI.
Sabouri and colleagues noted, however, that preadmission use of NSAIDs or dehydration was linked to a higher chance of AKI.
The findings “suggest that an elevated creatine kinase level is not a reliable indicator of AKI in hospitalized patients with ERM, but preadmission use of [NSAIDs] or dehydration appear to be associated with AKI,” they wrote.
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