Muscle and Compartmental Disorders Open access Peer reviewed

Factors associated with acute kidney injury in rhabdomyolysis: Insights from a prospective study

Hiba Ghabi, Amani Smai, Syrine Tlili, Lamia Rais and 6 more

World Journal of Nephrology | Jun 15, 2026

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Simple admission biomarkers such as LDH and bicarbonate should be considered for early AKI risk assessment in rhabdomyolysis, particularly in settings with limited access to advanced diagnostic tools.

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BACKGROUND Rhabdomyolysis is a common condition in intensive care units (ICUs), but data on acute kidney injury (AKI) associated with rhabdomyolysis remain limited, particularly in North Africa. AIM To determine the incidence of AKI during rhabdomyolysis and to identify its associated factors among ICU patients. METHODS We conducted a prospective, single-center correlational study from January to July 2024 in the ICU of Rabta University Hospital in Tunisia, including patients diagnosed with rhabdomyolysis. Clinical and laboratory parameters, along with the McMahon score, were assessed at the time of inclusion. Patients were then monitored during their ICU stay to detect the occurrence of AKI. RESULTS AKI occurred in 51.9% of the 54 patients included in the study. Univariate analysis identified several admission parameters associated with AKI, including elevated levels of creatine phosphokinase, lactate dehydrogenase (LDH), phosphorus, creatinine, and transaminases, as well as low bicarbonate and albumin levels. The optimal McMahon score threshold for predicting AKI was 4.75, with a sensitivity of 78.6% and specificity of 76.9%. In multivariate analysis, only initial LDH [P = 0.012; odds ratio (OR) = 0.993; 95%CI: 0.988-0.999] and initial bicarbonate (P = 0.025; OR = 1.553; 95%CI: 1.058-2.280) levels were independently associated with AKI occurrence. CONCLUSION Simple admission biomarkers such as LDH and bicarbonate should be considered for early AKI risk assessment in rhabdomyolysis, particularly in settings with limited access to advanced diagnostic tools.

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Hiba Ghabi

first

Amani Smai

middle

Syrine Tlili

middle

Lamia Rais

middle

Fethi Ben Hmida

middle

Bouthaina Mesbahi

middle

Ines Bounaouas

middle

Ikram Mami

middle

Yosri Messaoudi

middle | ORCID 0000-0003-3675-4712

Mouhamed Karim Zouaghi

last

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BibTeX

@article{Ghabi2026Factors,
  title = {Factors associated with acute kidney injury in rhabdomyolysis: Insights from a prospective study},
  author = {Hiba Ghabi and Amani Smai and Syrine Tlili and Lamia Rais and Fethi Ben Hmida and Bouthaina Mesbahi and Ines Bounaouas and Ikram Mami and Yosri Messaoudi and Mouhamed Karim Zouaghi},
  journal = {World Journal of Nephrology},
  year = {2026},
  doi = {10.5527/wjn.v15.i2.110379},
  url = {https://doi.org/10.5527/wjn.v15.i2.110379}
}

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