Characteristics of Creatine Kinase Elevation in Trauma Patients and Predictors of Acute Kidney Injury

Nawaporn Assanangkornchai ； Osaree Akaraborworn ； Chanon Kongkamol ； Khanitta Kaewsaengrueang

《Journal of Acute Medicine》 7卷2期 (2017/06) Pp. 54-60

https://doi.org/10.6705/j.jacme.2017.0702.002

摘要

Introduction: Rhabdomyolysis in general trauma patients is a cause of acute kidney injury. However, there are limited data on prevalence, risk factors and the dynamics of creatine kinase (CK) as a surrogate marker for rhabdomyolysis. Aim: This study aimed to examine the characteristics of CK elevation in general trauma patients and identify the risk factors of acute kidney injury (AKI). Method: A retrospective study of trauma patients at Songklanagarind Hospital from January 2009 to August 2014 using CK, clinical characteristics and trauma severity as predictors and AKI as defined by the Acute Kidney Injury Network, 2005 criteria as the outcomes. Results: Of the 372 patients included in the study, the prevalence of rhabdomyolysis was 40.3%, the mean injury severity score (ISS) was 19.5 and 7% had AKI. The CK level peaked at 40 hours after admission with a rate change of 50.98 U/L/h. An initial mean arterial pressure ＜ 65 mmHg, ISS ≥ 25 and CK elevation ＞ 1,000 U/L/h were independently associated with AKI. Conclusion: Traumatic rhabdomyolysis resulting in AKI occurs in patients with a high peak CK with an increasing rate of change and a high ISS. These parameters could identify patients who needed close monitoring of CK and renal function.

關鍵字

acute kidney injury ； creatine kinase ； rhabdomyolysis ； trauma