Trends in Pediatric Rhabdomyolysis and Associated Renal Failure: A 10-Year Population-Based Study

Abstract

OBJECTIVES: Rhabdomyolysis in children is a highly variable condition with presentations ranging from myalgias to more severe complications like acute renal failure. We sought to explore demographics and incidence of pediatric rhabdomyolysis hospitalizations and rates of associated renal failure, as our current understanding is limited. METHODS: This was a retrospective analysis using the Healthcare Cost and Utilization Project Kids’ Inpatient Database to identify children hospitalized with a primary diagnosis of rhabdomyolysis. Data were analyzed for demographic characteristics, as well as geographic and temporal trends. Multivariable logistic regression was used to identify characteristics associated with rhabdomyolysis-associated acute renal failure. RESULTS: From 2006 to 2016, there were 8599 hospitalized children with a primary diagnosis of rhabdomyolysis. Overall, hospitalizations for pediatric rhabdomyolysis are increasing over time, with geographic peaks in the South and Northeast regions, and seasonal peaks in March and August. Though renal morbidity was diagnosed in 8.5% of children requiring hospitalization for rhabdomyolysis, very few of these patients required renal replacement therapy (0.41%), and death was rare (0.03%). Characteristics associated with renal failure included male sex, age greater than 15 years, and non-Hispanic Black race. CONCLUSIONS: Though renal failure occurs at a significant rate in children hospitalized with rhabdomyolysis, severe complications, including death, are rare. The number of children hospitalized with rhabdomyolysis varies by geographic region and month of the year. Future studies are needed to explore etiologies of rhabdomyolysis and laboratory values that predict higher risk of morbidity and mortality in children with rhabdomyolysis.

Clinical features and use of renal replacement therapy in children who visit the emergency department with benign acute childhood myositis or rhabdomyolysis who visit the emergency department

“…횡문근융해증도 대개 바이러스 감염이 원인이지만, 과도한 운동, 약, 대사질환 등 더 다양한 원인을 가지며, 혈청 크레아틴인산화효소가 1,000 U/L 또는 정상 상한선의 5배 이상으로 증가한다 (3,4). 횡문근융해증 환자의 5.0%-35.9%에서 다양하게 급성콩팥손상을 유발할 수 있다고 보고됐지만, 관련된 한국 소아 보고는 적었다 (6)(7)(8)(9). 2).…”