Ghabi H, Smai A, Tlili S, Rais L, Ben Hmida F, Mesbahi B, Bounaouas I, Mami I, Messaoudi Y, Zouaghi MK. Factors associated with acute kidney injury in rhabdomyolysis: Insights from a prospective study. World J Nephrol 2026; 15(2): 110379 [DOI: 10.5527/wjn.v15.i2.110379]
Corresponding Author of This Article
Hiba Ghabi, Assistant Professor, Department of Nephrology, la Rabta University Hospital, Jbel Lakhdar Street, Tunis 1007, Tunisia. hiba.ghabi@fmt.utm.tn
Research Domain of This Article
Urology & Nephrology
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research-article
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Ghabi H, Smai A, Tlili S, Rais L, Ben Hmida F, Mesbahi B, Bounaouas I, Mami I, Messaoudi Y, Zouaghi MK. Factors associated with acute kidney injury in rhabdomyolysis: Insights from a prospective study. World J Nephrol 2026; 15(2): 110379 [DOI: 10.5527/wjn.v15.i2.110379]
Hiba Ghabi, Amani Smai, Syrine Tlili, Lamia Rais, Ikram Mami, Mouhamed Karim Zouaghi, Department of Nephrology, la Rabta University Hospital, Tunis 1007, Tunisia
Hiba Ghabi, Amani Smai, Syrine Tlili, Lamia Rais, Bouthaina Mesbahi, Ines Bounaouas, Ikram Mami, Yosri Messaoudi, Mouhamed Karim Zouaghi, Tunis El Manar University, Faculty of Medicine of Tunis, Tunis 1007, Tunisia
Fethi Ben Hmida, Research Laboratory LR00SP01, Charles Nicole University Hospital, Tunis 1007, Tunisia
Bouthaina Mesbahi, Ines Bounaouas, Yosri Messaoudi, Department of Intensive Care, la Rabta University Hospital, Tunis 1007, Tunisia
Author contributions: Ghabi H contributed to the conceptualization and methodology; Smai A conducted the investigation, performed the formal analysis, and wrote the original draft; Bounaouas I and Mesbahi B curated the data; Zouaghi MK, Hmida FB, and Messaoudi Y supervised the study; Ghabi H, Tlili S, Mami I, and Rais L contributed to the review and editing of the manuscript; all authors reviewed and approved the final manuscript.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of Rabta University Hospital.
Informed consent statement: All study participants or their legal guardians provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: The data presented in this study are available on request from the corresponding author due to privacy reasons.
Corresponding author: Hiba Ghabi, Assistant Professor, Department of Nephrology, la Rabta University Hospital, Jbel Lakhdar Street, Tunis 1007, Tunisia. hiba.ghabi@fmt.utm.tn
Received: June 7, 2025 Revised: July 23, 2025 Accepted: March 3, 2026 Published online: June 25, 2026 Processing time: 372 Days and 23.8 Hours
Abstract
BACKGROUND
Rhabdomyolysis is a common condition in intensive care units (ICUs), but data on acute kidney injury (AKI) associated with rhabdomyolysis remain limited, particularly in North Africa.
AIM
To determine the incidence of AKI during rhabdomyolysis and to identify its associated factors among ICU patients.
METHODS
We conducted a prospective, single-center correlational study from January to July 2024 in the ICU of Rabta University Hospital in Tunisia, including patients diagnosed with rhabdomyolysis. Clinical and laboratory parameters, along with the McMahon score, were assessed at the time of inclusion. Patients were then monitored during their ICU stay to detect the occurrence of AKI.
RESULTS
AKI occurred in 51.9% of the 54 patients included in the study. Univariate analysis identified several admission parameters associated with AKI, including elevated levels of creatine phosphokinase, lactate dehydrogenase (LDH), phosphorus, creatinine, and transaminases, as well as low bicarbonate and albumin levels. The optimal McMahon score threshold for predicting AKI was 4.75, with a sensitivity of 78.6% and specificity of 76.9%. In multivariate analysis, only initial LDH [P = 0.012; odds ratio (OR) = 0.993; 95%CI: 0.988-0.999] and initial bicarbonate (P = 0.025; OR = 1.553; 95%CI: 1.058-2.280) levels were independently associated with AKI occurrence.
CONCLUSION
Simple admission biomarkers such as LDH and bicarbonate should be considered for early AKI risk assessment in rhabdomyolysis, particularly in settings with limited access to advanced diagnostic tools.
Core Tip: To the best of our knowledge, this is the first prospective study specifically designed to explore factors associated with rhabdomyolysis-induced acute kidney injury. Our findings provide important clinical insights for nephrologists. These results may enhance risk stratification at the time of admission, allowing for earlier implementation of targeted preventive strategies and closer monitoring of renal function, ultimately contributing to improved patient outcomes.
