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Research Article Volume 14 Issue 3
Changing spectrum and outcomes of rhabdomyolysis-induced acute kidney injury: A 35 years update form tertiary care unit
Rubina Naqvi, Khawar Abbas, Mehr Afroz
Received: August 11, 2026 | Published: September 1, 2026
Citation: Naqvi R, Abbas K, Afroz M. Changing spectrum and outcomes of rhabdomyolysis-induced acute kidney injury: A 35 years update form tertiary care unit. Urol Nephrol Open Access J. 2026;14(2):77-82. DOI: 10.15406/unoaj.2026.14.00378
Abstract
Background: The skeletal muscle injury and the release of myoglobin into circulation can cause acute kidney injury (AKI), this could be exertional, traumatic, or non-traumatic, nonexertional. We hereby report AKI in association with rhabdomyolysis, its pattern over 35 years among causes, course of illness, management, and outcome. Methods: This is a retrospective cohort study performed at a tertiary renal care center. From January 1990 to December 2024, case records of all patients who satisfied the KDIGO definition of AKI, developing it after Rhabdomyolysis, were reviewed, and data were collected and analyzed. Rhabdomyolysis was suspected on history and clinical findings and confirmed when Creatine Kinase levels were more than 3 times the maximum reference range. Other causes of AKI were excluded. Results were analyzed on SPSS, and parameters were compared among those who showed complete renal recovery with both; those who died during acute illness or did not reveal complete renal recovery/ lost follow up before 90 days from the start of illness. Results: A previous report on 25 years of these patients (334 in number) was published. During last 10-year period, another 121 cases of Rhabdomyolysis-associated AKI were seen. Mean age was 28.22±11.22 and 33.59±14.09 years (in the previous 334 and current 121 patients, respectively). We compared causes of rhabdomyolysis, course of illness, and outcome over decades. Most prominent changes among causes were that torture-related rhabdomyolysis was more common from 1990-2009, while paraphenylene diamine poisoning (PPD) causing toxic rhabdomyolysis was very high between 2010 and 2014. The rest of causes show little variations. Among outcome main change in pattern was a higher number of patients (20%) lost follow up after first discharge from hospital during last ten years, as compared to the initial 25 years when most of patients were coming for long-term follow-up. Overall, 92% of patients required renal replacement therapy (94% during initial twenty-five years and 88% during last ten years) Conclusion: Decline in the number of torture-related rhabdomyolysis, which was more during the initial 20 years with political instability, and then sharp rise in PPD-related toxic rhabdomyolysis during 5 years with emotional instability (as in the majority PPD was ingested for self-harm). Later, extensive public awareness campaigns lowered the number of these cases over the last ten years. With expansion of services and increasing number of patient turnover, we are losing control of effective follow-up.
Keywords: AKI, acute kidney injury; rhabdomyolysis, PPD, para phenylene diamine; torture, RRT, renal replacement therapy
©2026 Naqvi, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.