BACKGROUND Rhabdomyolysis is a life-threatening disease that can lead to severe hyperkalemia, acute kidney injury (AKI) and hypovolemic shock. The predictive factors of AKI and acute to chronic kidney disease (CKD) transition remain poorly described. METHODS This multicenter retrospective study enrolled 387 patients with severe rhabdomyolysis (CPK > 5000 U/L). Primary end-point was the development of severe AKI, defined as stage 2 or 3 of KDIGO classification. Secondary end-points included the incidence of AKI to CKD transition. RESULTS Among the 387 patients, 315 (81.4%) developed AKI, including 171 (44.1%) with stage 3 AKI and 103 (26.6%) requiring RRT. Stage 2-3 AKI was strongly correlated with serum phosphate, potassium and bicarbonate at admission, as well as myoglobin over 8000 U/L and the need for mechanical ventilation. 42 patients (10.8%) died before day 28. In the 80 patients with available eGFR values both before and 3 months after the rhabdomyolysis, the decrease in eGFR (greater than 20 mL/min/1.73 m2 in 23 patients; 28.8%) was correlated to the severity of the AKI and serum myoglobin levels > 8000 U/L at admission. CONCLUSIONS Severe rhabdomyolysis leads to AKI in most patients admitted to an ICU. Mechanical ventilation and severity of the rhabdomyolysis, including myoglobin level, are associated with the risk of stage 2-3 AKI. The long-term renal decline is correlated to serum myoglobin at admission.

中文翻译：

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严重横纹肌溶解症后短期和长期肾脏预后：一项针对387例患者的法国多中心回顾性研究。

背景技术横纹肌溶解症是一种威胁生命的疾病，可导致严重的高钾血症，急性肾损伤（AKI）和低血容量性休克。AKI和急性至慢性肾脏病（CKD）过渡的预测因素仍然描述得很差。方法这项多中心回顾性研究纳入了387例严重横纹肌溶解症（CPK> 5000 U / L）的患者。主要终点是严重AKI的发生，定义为KDIGO分类的第2或第3阶段。次要终点包括AKI向CKD过渡的发生率。结果在387例患者中，有315例（81.4％）发生了AKI，包括171例（44.1％）的3期AKI和103例（26.6％）的需要进行RRT。2-3期AKI与入院时的血清磷酸盐，钾和碳酸氢盐以及超过8000 U / L的肌红蛋白以及需要机械通气密切相关。42名患者（10.8％）在第28天前死亡。在80名在横纹肌溶解术之前和之后三个月均具有可用eGFR值的患者中，eGFR下降（23名患者大于20 mL / min / 1.73 m2； 28.8％）。与入院时AKI的严重程度和血清肌红蛋白水平> 8000 U / L相关。结论严重横纹肌溶解症导致大多数入住ICU的患者发生AKI。机械通气和横纹肌溶解的严重程度（包括肌红蛋白水平）与2-3级AKI的风险有关。入院时长期肾脏功能下降与血清肌红蛋白相关。8％）与AKI的严重程度和入院时血清肌红蛋白水平> 8000 U / L相关。结论严重横纹肌溶解症导致大多数入住ICU的患者发生AKI。机械通气和横纹肌溶解的严重程度（包括肌红蛋白水平）与2-3级AKI的风险有关。入院时长期肾脏功能下降与血清肌红蛋白相关。8％）与AKI的严重程度和入院时血清肌红蛋白水平> 8000 U / L相关。结论严重横纹肌溶解症导致大多数入住ICU的患者发生AKI。机械通气和横纹肌溶解的严重程度（包括肌红蛋白水平）与2-3级AKI的风险有关。入院时长期肾脏功能下降与血清肌红蛋白相关。