Earlier CRRT is Associated with Reduced Mortality in Rhabdomyolysis Patients

Background: Continue renal replacement therapy (CRRT) is commonly employed for rhabdomyolysis (RM) patients. However, the optimal initiation timing of CRRT and prognostic factors were not well evaluated for patients with RM. We aimed to investigate the efficacy of CRRT timing on mortality and the risk factors of death in RM patients who accepted CRRT.Methods: RM patients who received CRRT between May 2010 and May 2021 in our center were retrospectively included. The primarily endpoint was 90-day mortality. Univariate and multivariate logistic analyses were performed to identify the risk factors of 90-day mortality.Results: A total of 134 patients were included in our present study. The 90-day mortality rate was 38.06%. Most of the patients (88.81%) reached peak creatine kinase (CK) within 72 hours after admission, and 58 (43.28%) patients received CRRT before the peak CK occurrence (earlier CRRT) and 76 (56.72%) of patients had CRRT after the peak CK occurrence (later CRRT). Multivariate logistic regression analysis showed that CRRT initiation after the peak CK occurrence (OR = 3.74, 95%CI 1.17-11.95, p = 0.026), the elevated serum cTnI (OR = 1.23, 95%CI 1.02-1.49, p = 0.032), and the need of mechanical ventilation support (OR = 7.18, 95%CI 1.67-30.83, p = 0.008) were independent risk factors of 90-day mortality. Similar results were obtained in a subgroup analysis of patients with acute kidney injury (AKI).Conclusions: Earlier CRRT initiation before the peak CK occurrence was associated with lower 90-day patient mortality.