Discriminant Analysis on Acute Renal Failure from Rhabdomyolysis after Drug Intoxication

Kim,  Hyung Min; Lee,  Mi Jin; So,  Byung Hak; Lee,  Won Jae; Kim,  Se Kyung

J Korean Soc Emerg Med > Volume 15(2); 2004 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2004;15(2): 117-124.

Discriminant Analysis on Acute Renal Failure from Rhabdomyolysis after Drug Intoxication

Hyung Min Kim, Mi Jin Lee, Byung Hak So, Won Jae Lee, Se Kyung Kim

Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. emmam@catholic.ac.kr

ABSTRACT

PURPOSE:
Acute renal failure is one of the most serious complications of rhabdomyolysis after drug intoxication and may increase morbidity and mortality. The aim of this study was to determine the predictive factors of acute renal failure (ARF) associated with drug intoxication.
METHODS:
We reviewed retrospectively the medical records of patients admitted for drug intoxication from January 2001 to April 2003 at our emergency department. Patients with drug intoxication whose plasma levels of creatinine phosphokinase were higher than 1,000 IU were included in this study. We identified 61 patients. The entire population is divided into those with initial serum creatinine concentrations less than 2.0 mg/dL (non-azotemic) and those with initial serum creatinine greater than 2.0 mg/dL (azotemic). The initially non-azotemic group is subdivided into patients who developed acute renal failure (RFD) and those who didn't (NRF) after admission. We evaluated them with respect to the ingested drug, age and sex, time from ingestion to visit, past history, vital signs, laboratory data and blood gas analysis.
RESULTS:
Five patients (9.4%) developed ARF in nonazotemic group. Discriminant analysis revealed that early predictors for ARF were BUN, calcium, ALT, LDH, arterial blood pH and oxygen saturation. The result was R = 0.13[BUN]+11.9[pH]+0.14[oxygen saturation]-0.66[calcium ] + 0.01 [ALT]-0.01[LDH]-88.4. Therefore R value < 0 was predictive of ARF with an accuracy of 96.2%. CONCILUSION: We could identify early predictive risk factors. These factors may help provide future strategies.

Key words: Rhabdomyolysis, Acute renal failure, Poisoning