Ramazan Guven: Health Science University, Istanbul Cam and Sakura City Research and Training Hospital, Department of Emergency Medicine, Istanbul, Turkey. Electronic address: drramazanguven@gmail.com.
Akkan Avci: Health Science University, Adana City Research and Training Hospital, Department of Emergency Medicine, Adana, Turkey.
Semih Korkut: Health Science University, Istanbul Cam and Sakura City Research and Training Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Ertugrul Altug: Health Science University, Istanbul Cam and Sakura City Research and Training Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Adem Cakir: Canakkale Mehmet Akif Ersoy State Hospital, Canakkale, Turkey.
Ozgur Sogut: Health Science University, Istanbul Haseki Research and Training Hospital, Department of Emergency Medicine, Istanbul, Turkey. Electronic address: ozgur.sogut@sbu.edu.tr.
Serkan Dogan: Health Science University, Istanbul Kanuni Sultan Suleyman Research and Training Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Mustafa Avsar: Yuregir State Hospital, Emergency Medicine Clinic, Adana, Turkey.
Gulcin Hilal Alay: Health Science University, Istanbul Cam and Sakura City Research and Training Hospital, Department of Nephrology, Istanbul, Turkey.
Gulay Yilmaz: Health Science University, Istanbul Cam and Sakura City Research and Training Hospital, Department of Nephrology, Istanbul, Turkey.
PURPOSE: This study had two main goals: to determine which rhabdomyolysis patients need haemodialysis; and to highlight the significance of blood gas parameters, particularly base excess, as predictors of the need for haemodialysis. METHOD: A total of 270 patients were included in this multicentre, retrospective study. Among the patients who were transferred in from the earthquake region and developed rhabdomyolysis, those with creatine kinase (CK) values >1000 U/L were included in our study. The need for renal replacement in these patients was determined via laboratory tests, urine output monitoring and clinical follow-up. FINDINGS: A total of 270 patients were included in our study. Univariate and multivariate regression analyses of laboratory parameters were performed to identify predictors of HD treatment. According to the univariate regression analysis, BE, HCO3, creatinine, CK, lactate, alanine transaminase (ALT) and aspartate transaminase (AST) levels were found to be significantly associated with receiving HD treatment. According to multivariate regression analysis, only BE (p = 0.003) was found to be a significant predictor of HD treatment. ROC analysis revealed that the optimal cutoff value for BE was -2.6; at this value, the sensitivity and specificity of BE for predicting HD treatment were 89% and 77.1%, respectively (AUC: 0.912; 95% CI: 0.872-0.943; p < 0.001). CONCLUSION: Base excess is an effective predictor of the need for haemodialysis in patients with crush-related injuries that cause rhabdomyolysis and in patients who develop acute renal failure due to elevated CK.
