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Clinical characteristics of acute renal failure of rhabdomyolysis in children

Korean Journal of Pediatrics 2007;50(3):277-283.
Published online March 15, 2007.
Clinical characteristics of acute renal failure of rhabdomyolysis in children
Jae Hui Kim, Min Ji Goo, Jung Sook Yeom, Eun Sil Park, Ji Hyun Seo, Jae Young Lim, Chan Hoo Park, Hyang Ok Woo, Hee Shang Youn
Department of Pediatrics, College of Medicine, The Gyeongsang National University, Jinju, Korea
소아에서 횡문근융해증을 동반한 급성신부전의 임상양상
김재희, 구민지, 염정숙, 박은실, 서지현, 임재영, 박찬후, 우향옥, 윤희상
경상대학교 의과대학 소아과학교실
Correspondence: 
Jae Young Lim, Email: pedneu@gsnu.ac,kr
Abstract
Purpose
: Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF.
Methods
: A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency.
Results
: Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis.
Conclusion
: Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.
Key Words: Acute renal failure , Rhabdomyolysis , Child


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