Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome

In rhabdomyolysis, the most serious systemic complication is acute kidney injury (AKI), which is associated with the need for renal replacement therapy (RRT) and poor outcome. To identify the factors predictive of the need for RRT in critically ill patients with rhabdomyolysis and their outcome.This...

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Main Author: Wei, Tan Chee
Format: Thesis
Language:English
Published: 2020
Subjects:
Online Access:http://eprints.usm.my/56935/1/Tan%20Chee%20Wei%20-%20e%2024.pdf
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author Wei, Tan Chee
author_facet Wei, Tan Chee
author_sort Wei, Tan Chee
collection USM
description In rhabdomyolysis, the most serious systemic complication is acute kidney injury (AKI), which is associated with the need for renal replacement therapy (RRT) and poor outcome. To identify the factors predictive of the need for RRT in critically ill patients with rhabdomyolysis and their outcome.This was a prospective observational study conducted in the intensive care unit (ICU) of the Hospital Universiti Sains Malaysia over a 1 year period. Consecutive adult patients admitted to the ICU who fulfilled the criteria of rhabdomyolysis at any point during their ICU stay were recruited. Obvious cases of renal failure and pre-existing use of RRT were excluded. Data on factors that are known to predict the need for RRT were recruited. The end point of the study was initiation of RRT during the ICU stay and the outcome. Univariate analysis was performed to identify the factors that were significantly associated with the initiation of RRT. A total of 30 subjects fulfilled the study criteria, of which 4 (13.3%) of them required RRT and 3 (10.0%) death reported. The subject’s APACHE II and SOFA median scores were 9.0 (IQR=14.0) and 3.5 (IQR=6.3), respectively. Majority of the rhabdomyolysis patients 28 (93.3%) were due to trauma. Factors that showed significant association with RRT include SOFA score (P=0.021), peak serum creatine kinase level (P=0.026), peak serum creatinine level (P=0.024), use of sodium bicarbonate (P=0.037), and length of ICU stay (P=0.026). In this study, higher SOFA, peak CK level, peak creatinine level, use of sodium bicarbonate and longer length of stay ICU were the predictive factors leading to initiation of RRT in critically ill patients.
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spelling usm.eprints-569352023-02-14T08:43:46Z http://eprints.usm.my/56935/ Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome Wei, Tan Chee R735-854 Medical education. Medical schools. Research RC870-923 Diseases of the genitourinary system. Urology In rhabdomyolysis, the most serious systemic complication is acute kidney injury (AKI), which is associated with the need for renal replacement therapy (RRT) and poor outcome. To identify the factors predictive of the need for RRT in critically ill patients with rhabdomyolysis and their outcome.This was a prospective observational study conducted in the intensive care unit (ICU) of the Hospital Universiti Sains Malaysia over a 1 year period. Consecutive adult patients admitted to the ICU who fulfilled the criteria of rhabdomyolysis at any point during their ICU stay were recruited. Obvious cases of renal failure and pre-existing use of RRT were excluded. Data on factors that are known to predict the need for RRT were recruited. The end point of the study was initiation of RRT during the ICU stay and the outcome. Univariate analysis was performed to identify the factors that were significantly associated with the initiation of RRT. A total of 30 subjects fulfilled the study criteria, of which 4 (13.3%) of them required RRT and 3 (10.0%) death reported. The subject’s APACHE II and SOFA median scores were 9.0 (IQR=14.0) and 3.5 (IQR=6.3), respectively. Majority of the rhabdomyolysis patients 28 (93.3%) were due to trauma. Factors that showed significant association with RRT include SOFA score (P=0.021), peak serum creatine kinase level (P=0.026), peak serum creatinine level (P=0.024), use of sodium bicarbonate (P=0.037), and length of ICU stay (P=0.026). In this study, higher SOFA, peak CK level, peak creatinine level, use of sodium bicarbonate and longer length of stay ICU were the predictive factors leading to initiation of RRT in critically ill patients. 2020 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/56935/1/Tan%20Chee%20Wei%20-%20e%2024.pdf Wei, Tan Chee (2020) Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome. Masters thesis, Universiti Sains Malaysia.
spellingShingle R735-854 Medical education. Medical schools. Research
RC870-923 Diseases of the genitourinary system. Urology
Wei, Tan Chee
Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome
title Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome
title_full Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome
title_fullStr Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome
title_full_unstemmed Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome
title_short Factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome
title_sort factors predictive of the need for renal replacement therapy in critically ill patients with rhabdomyolysis and their outcome
topic R735-854 Medical education. Medical schools. Research
RC870-923 Diseases of the genitourinary system. Urology
url http://eprints.usm.my/56935/1/Tan%20Chee%20Wei%20-%20e%2024.pdf
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