Rhabdomyolysis in an HIV cohort: epidemiology, causes and outcomes

BMC Nephrology

Research Article

Richard D. Moore¹  Gregory M. Lucas¹  Sahar H. Koubar²  Derek M. Fine³  Mohamed G. Atta³  Michelle M. Estrella⁴  Rugmini Warrier⁵ 

[1] Department of Medicine/Division of Infectious Diseases, Johns Hopkins University Hospital and School of Medicine, 1830 E. Monument St., Room 435A, 21287, Baltimore, MD, USA;Department of Medicine/Division of Nephrology, American University of Beirut Medical Center and School of Medicine, PO Box 11-0236, Riad El Solh, 1107 2020, Beirut, Lebanon;Department of Medicine/Division of Nephrology, Johns Hopkins University Hospital and School of Medicine, 1830 E. Monument Street - Suite 416, 21205, Baltimore, MD, USA;Kidney Health Research Collaborative, San Francisco VA Medical Center and University of California, 4150 Clement St., 111A1, 94121, San Francisco, California, CA, USA;Lincoln Nephrology & Hypertension, Lincoln, 7441 O St., Suite 304, 68510, Nebraska, USA;

关键词: Acute kidney injury;    AIDs;    Creatinine kinase;    HIV;    Rhabdomyolysis;   

DOI  :  10.1186/s12882-017-0656-9

 received in 2017-03-31, accepted in 2017-07-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe Literature on rhabdomyolysis in the HIV-positive population is sparse and limited. We aimed to explore the incidence, patient characteristics, etiologies and outcomes of rhabdomyolysis in a cohort of HIV-positive patients identified through the Johns Hopkins HIV clinical registry between June 1992 and April 2014.MethodsA retrospective analysis of 362 HIV-positive patients with non-cardiac CK elevation ≥1000 IU/L was performed. Both inpatients and outpatients were included. Incidence rate and potential etiologies for rhabdomyolysis were ascertained. The development of acute kidney injury (AKI, defined as doubling of serum creatinine), need for dialysis, and death in the setting of rhabdomyolysis were determined. Logistic regression was used to evaluate the association of peak CK level with the development of AKI.ResultsThree hundred sixty two cases of rhabdomyolysis were identified in a cohort of 7079 patients with a 38,382 person years follow-up time. The incidence rate was nine cases per 1000 person-years (95% CI: 8.5–10.5). Infection was the most common etiology followed by compression injury and drug/alcohol use. One-third of cases had multiple potential etiologies. AKI developed in 46% of cases; 20% of which required dialysis. Thirteen percent died during follow-up. After adjustment, AKI was associated with higher CK (OR 2.05 for each 1-log increase in CK [95% CI: 1.40–2.99]), infection (OR 5.48 [95% CI 2.65–11.31]) and higher HIV viral load (OR 1.22 per 1-log increase [95% CI: 1.03–1.45]).ConclusionRhabdomyolysis in the HIV-positive population has many possible causes and is frequently multifactorial. HIV-positive individuals with rhabdomyolysis have a high risk of AKI and mortality.

【 授权许可】

CC BY   
© The Author(s). 2017