Factors associated with acute kidney injury in rhabdomyolysis: Insights from a prospective study

doi:10.5527/wjn.v15.i2.110379

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Nephrol. Jun 25, 2026; 15(2): 110379
Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.110379

Table 1 Calculation of the McMahon score

Variable	Value	Points
Age (years)	50–70	1.5
	71–80	2.5
	> 80	3
Women		1
Admission creatinine (μmol/L)	124–194	1.5
Admission creatinine (μmol/L)	> 194	3
Admission calcium (mmol/L)	< 1.875	2
Admission creatinine kinase (UI/L)	> 40000	2
Etiology	Not seizures, syncope, exercise, statins or myositis	3
Initial phosphate (mmol/L)	1.3-1.74	1.5
Initial phosphate (mmol/L)	> 1.74	3
Initial bicarbonate (mmol/L)	< 19	2

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Table 2 Baseline demographic characteristics and comorbidities of patients with rhabdomyolysis: Comparison between those who developed acute kidney injury and those who did not, n (%)/mean ± SD

Variables	All patients (n = 54)	AKI group (n = 28)	Non-AKI group (n = 26)	P value
Age (years)	46.1 ± 17.9	50.2 ± 17.3	41.8 ± 17.8	0.087
Gender				0.381
Male	43 (79.6)	21 (75)	22 (84.6)
Female	11 (20.4)	7 (25)	4 (15.4)
Smoking	35 (64.8)	16 (57.1)	19 (73.1)	0.221
Comorbidities
Diabetes	10 (18.5)	8 (28.6)	2 (7.7)	0.05
Dyslipidemia	14 (25.9)	11 (39.3)	3 (11.5)	0.02
Hypertension	14 (25.9)	9 (32.1)	5 (19.2)	0.279
Coronary artery disease	10 (18.5)	4 (14.3)	6 (23.1)	0.406
Chronic heart failure	4 (7.4)	3 (10.7)	1 (3.8)	0.336
Chronic kidney disease	3 (5.6)	2 (7.1)	1 (3.8)	0.597
Regular treatment before admission to the intensive care unit
Oral antidiabetics	6 (11.1)	4 (14.3)	2 (7.7)	0.44
Insulin therapy	6 (11.1)	5 (17.9)	1 (3.8)	0.114
Statin	13 (24.1)	8 (28.6)	5 (19.2)	0.422
Renin-angiotensin system blockers	5 (9.3)	2 (7.1)	3 (11.5)	0.464
Oral furosemide	6 (11.1)	3 (10.7)	3 (11.5)	0.629
Causes of rhabdomyolysis				0.001
Traumatic	23 (42.6)	6 (21.4)	17 (65.4)
Non traumatic	31 (57.4)	22 (78.6)	9 (34.6)

AKI: Acute kidney injury.

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Table 3 Baseline clinical data of patients with rhabdomyolysis: Comparison between those who developed acute kidney injury and those who did not, mean ± SD

Variables	All patients (n = 54)	AKI group (n = 28)	Non-AKI group (n = 26)	P value
SBP (mmHg)	120.2 ± 23.5	121.2 ± 25.4	119.1 ± 21.9	0.752
DBP (mmHg)	69.2 ± 14.1	68.2 ± 13.9	70.23 ± 14.5	0.605
MAP (mmHg)	86.2 ± 12.2	85.8 ± 12.5	86.5 ± 12.1	0.21
Heart rate (beats per minute)	91.5 ± 24.8	90.2 ± 21.1	93 ± 28.6	0.688
Diuresis (mL/hour)	66 ± 28.1	62 ± 35	70.5 ± 17.7	0.254

SBP: Systolic blood pressure; DBP: Diastolic blood pressure; MAP: Mean arterial pressure; AKI: Acute kidney injury.

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Table 4 Baseline laboratory data and McMahon score of patients with rhabdomyolysis: Comparison between those who developed acute kidney injury and those who did not, mean ± SD/median (25^th-75^th percentiles)

Variables	All patients (n = 54)	AKI group (n = 28)	Non-AKI group (n = 26)	P value
CPK (UI/L)	2151 (1340-3729)	2868 (1410.7-9178.2)	2004 (1216-2426.7)	0.04
LDH (U/L)	580 (315-95)	877.5 (665.5-1793)	321.5 (286-406.7)	< 0.001
Corrected serum calcium (mmol/L)	2.3 ± 0.1	2.32 ± 0.2	2.3 ± 0.1	0.562
Phosphorus level (mmol/L)	1.07 ± 0.6	1.2 ± 0.8	0.82 ± 0.2	0.024
Serum bicarbonate (mmol/L)	22.25 ± 4.3	20.1 ± 4.2	24.5 ± 3.3	< 0.001
Urea (mmol/L)	6.8 (5-11.6)	10 (6.8-15.2)	4.9 (3.2-6.5)	0.001
Serum creatinine, (μmol/L)	82.5 (63.8-152.8)	149.4 (97.5-189)	66 (50.7-81.4)	< 0.001
Potassium level (mmol/L)	4.15 ± 0.8	4.3 ± 0.8	3.9 ± 0.6	0.147
Albumin level (g/L)	27.92 ± 5.1	26.3 ± 5.8	29.7 ± 3.6	0.017
AST (UI/L)	80 (55-178)	139 (69.5-202)	58.5 (44-94)	< 0.001
ALT (UI/L)	38.5 (23-76.5)	51.5 (27-91)	25 (20-44)	0.038
Total cholesterol (mmol/L)	3.65 ± 1.2	3.7 ± 1.5	3.5 ± 0.7	0.439
LDLc (mmol/L)	2.4 ± 1.1	2.4 ± 1.4	2.3 ± 0.7	0.724
Glycemia (mmol/L)	7.34 ± 3.7	8.1 ± 4.2	6.5 ± 2.8	0.126
C-reactive protein (mg/L)	150.61 ± 113.1	167.6 ± 128.7	132.3 ± 92.3	0.255
Hemoglobin (g/dL)	10.1 ± 2.2	9.9 ± 2.2	10.2 ± 2.05	0.674
White blood cells per liter	14776.8 ± 5970.2	14935.4 ± 6865.4	14606.2 ± 4960	0.842
Prothrombin time (%)	67.17 ± 18.5	60.6 ± 16.8	74.2 ± 18	0.006
McMahon score	5.78 ± 3	7.2 ± 3.9	4.1 ± 1.39	< 0.001

CPK: Creatinine phosphokinase; LDH: Lactate dehydrogenase; AST: Aspartate transaminase; ALT: Alanine transaminase; LDLc: Low-density lipoprotein cholesterol; AKI: Acute kidney injury.

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Table 5 Medical management and intensive care unit stay-related complications of patients with rhabdomyolysis: Comparison between those who developed acute kidney injury and those who did not, n (%)

Variables	All patients (n = 54)	Non-AKI group (n = 26)	AKI group (n = 28)	P value
Hydration	48 (88.9)	26 (100)	22 (78.6)	0.012
Infection	38 (70.4)	15 (57.7)	23 (82.1)	0.049
Antibiotics	40 (74.1)	17 (65.4)	21 (75)	0.439
Amoxicillin-clavulanic acid	19 (35.2)	11 (42.3)	8 (28.6)	0.352
Piperacillin/tazobactam	17 (31.5)	9 (34.6)	8 (28.6)	0.753
Cefazolin	2 (3.7)	0 (0)	2 (7.1)	0.244
Cefotaxime	7 (13)	1 (3.8)	6 (21.4)	0.053
Imipenem	13 (24.1)	3 (11.5)	10 (35.7)	0.034
Gentamicin	4 (7.4)	1 (3.8)	3 (10.7)	0.606
Amikacin	17 (31.5)	10 (38.5)	7 (25)	0.242
Vancomycin	1 (1.9)	0 (0)	1 (3.6)	0.523
Teicoplanin	5 (9.3)	1 (3.8)	4 (14.3)	0.202
Metronidazole	3 (5.6)	1 (3.8)	2 (7.1)	0.535
Colistin	5 (9.3)	0 (0)	5 (17.9)	0.023
Fluoroquinolone	4 (7.4)	1 (3.8)	3 (10.7)	0.303
Quinolone	2 (3.7)	0 (0)	2 (7.1)	0.267
States of shock	17 (31.5)	7 (26.9)	10 (35.7)	0.487
Contrast agent use	35 (64.8)	12 (46.2)	23 (82.1)	0.006

AKI: Acute kidney injury.

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Citation: 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
URL: https://www.wjgnet.com/2220-6124/full/v15/i2/110379.htm
DOI: https://dx.doi.org/10.5527/wjn.v15.i2.110379

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]

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