WCN26-6545 ACUTE KIDNEY INJURY (AKI) CAUSED BY RHABDOMYOLYSIS SUCCESSFULLY TREATED WITH HEMODIALYSIS (HD) or HEMODIAFILTRATION (HDF): CASE SERIES

Introduction: Renal replacement therapy (RRT) has been reported to be effective in patients with AKI due to rhabdomyolysis.We report 8 cases of AKI caused by rhabdomyolysis treated with RRT, and we discuss potential contributing factors.Methods: Case Series;Case 1:39-year-old man with schizophrenia was brought to the emergency room (ER) due to impaired mobility.Laboratory tests revealed a creatinine (sCr) of 4.94 mg/dL, creatine kinase (CK) of 341,500 IU/L, and myoglobin (sMb) of 160,000 ng/mL.The clinical condition improved after continuous hemodiafiltration (CHDF) for 5 days and 6 HD sessions.Case 2: 47-year-old man with bipolar disorder was brought to the ER due to impaired mobility in a hot environment.Lab data; sCr 6.24 mg/dL, CK 5,258 IU/L, sMb 5,738 ng/mL.The clinical condition improved after 9 HD sessions.Case 3:74-year-old woman with schizophrenia was brought to the ER by impaired mobility in a hot environment.Lab data; sCr 5.94 mg/ dL, CK 21,300 IU/L, sMb 1,589 ng/mL.The clinical condition improved after 3 HDF and 3 HD sessions.Case 4:76-year-old man with chronic kidney disease was brought to the ER due to impaired mobility in a hot environment.Lab data; sCr 5.07 mg/dL, CK 162,400 IU/L, sMb 2,007 ng/mL.The clinical condition improved after 12 HD sessions.Case 5:25-year-old man was brought to the ER with status epilepticus.Lab data; sCr 2.67 mg/dL, CK 68,800 IU/L, sMb 180,000 ng/ mL.The clinical condition improved after 3 days of CHDF and 10 HDF sessions.Case 6:67-year-old man with multiple cardiovascular diseases was brought to the ER due to impaired mobility.Lab data; sCr 3.46 mg/dL, CK 25,580 IU/L, sMb 7,188 ng/mL.The clinical condition improved after 6 HD sessions.Case 7:60-year-old man with peripheral arterial disease was brought to the ER due to developed bilateral leg swelling after sitting crosslegged.Lab data; sCr 10.8 mg/dL, CK 95,550 IU/L, sMb 576 ng/mL.The clinical condition improved after 3 HDF and 2 HD sessions.Case 8:81-year-old woman with schizophrenia was brought to the ER due to impaired mobility.Lab data; sCr 5.48 mg/dL, CK 48,060 IU/L, sMb 26,000 ng/mL.The clinical condition improved after 3 days of CHDF and 4 HD sessions.Results: The causes of rhabdomyolysis can be categorized into traumatic and non-traumatic.Identified precipitating factors included medication use, dehydration (e.g., alcohol consumption or hot environments), seizures, and muscle compression.Statins and antipsychotics are well-known pharmacologic causes.In our series, 4 patients were taking antipsychotic medications, 4 were exposed to hot environment, 2 had consumed alcohol, 2 experienced muscle compression, and 1 had seizures.;suggesting that antipsychotic use and hot environment were predominant contributing factors.The mechanisms of AKI in rhabdomyolysis include tubular obstruction by myoglobin, and renal ischemia.Aggressive intravenous hydration to maintain adequate urine output is essential.RRT may be required when fluid resuscitation alone is insufficient. Conclusion:We reported 8 cases of AKI caused by rhabdomyolysis treated with RRT.Elimination of the underlying precipitating factors is essential even after clinical improvement.The recent rise in summer temperatures in Japan may increase the risk of rhabdomyolysis, underscoring clinical vigilance.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.