Sex influence on acute kidney injury associated to rhabdomyolysis: a retrospective cohort.

• Grant number: 24/22177-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: May 01, 2025
• End date: October 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Heitor Siqueira Ribeiro
• Grantee: Bruna Florentino Diniz Silva
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

INTRODUCTION: Rhabdomyolysis is caused by the breakdown of skeletal muscle cells, which accumulate in the systemic circulation. Due to the release of intracellular contents, such as myoglobin, there is an electrolyte imbalance among cells, increasing the risk of developing acute kidney injury (AKI), as these extravasated components are highly toxic to renal tubular cells. AKI is not an uncommon complication of rhabdomyolysis and is associated with higher mortality in affected patients. JUSTIFICATION: Data on the role of sex in AKI associated with rhabdomyolysis are scarce. Studies report the influence of sex on AKI outcomes or rhabdomyolysis alone; however, no study has demonstrated the impact of biological sex when these conditions are concomitant. OBJECTIVES: The objective of this study is to assess the influence of biological sex on the outcomes of AKI associated with rhabdomyolysis. METHODS: Medical records of patients admitted to the Central Institute of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo (HCFMUSP), São Paulo, from 2018 to 2019 who developed AKI following a diagnosis of rhabdomyolysis will be used. The diagnosis of hospital-acquired AKI will be defined by the modified KDIGO criteria, that is, an increase of >0.3 mg/dl in serum creatinine (SCr) within 48 hours, or an increase >1.5 times the baseline SCr within a week. The diagnosis of rhabdomyolysis will be defined as CPK >1,540 U/L for men and >960 U/L for women (based on the reference values of the HCFMUSP Central Laboratory Division). The primary outcomes analyzed will be the severity of AKI and recovery of renal function. EXPECTED RESULTS: More cases of severe AKI associated with rhabdomyolysis are expected to be found in men.