Login to Access Video or Poster Abstract: MP59-17
Sources of Funding: None

Introduction

Rare cases of clinically apparent rhabdomyolysis have been reported in patients undergoing minimally invasive urologic surgery. This study aims to estimate the incidence of subclinical postoperative rhabdomyolysis and determine its effect on renal function._x000D_

Methods

Daily postoperative serum creatinine kinase level was prospectively collected on 1034 patients who underwent urologic surgery. Rhabdomyolysis was defined as serum creatinine kinase (CK) ≥1000 U/L. Univariate and multivariate analysis was performed in order to identify factors associated with postoperative rhabdomyolysis. Patients were stratified by degree of CK elevation. Kruskal-Wallis tests were performed in order to determine the association between degree of CK elevation and peak postoperative serum creatinine level. p < 0.05 indicated statistical significance.

Results

Rhabdomyolysis occurred in 13.7% of patients (142/1034), with 97.2% (138/142) being subclinical. On multivariable analysis, sex, BMI, operative time, use of a hand-assisted surgical approach, and flank position were associated with development of rhabdomyolysis. Subclinical rhabdomyolysis was associated with postoperative acute kidney injury in surgeries involving complete loss of renal unit, with higher peak serum CK levels being associated with higher peak serum creatinine levels (Table 1).

Conclusions

Rhabdomyolysis is often clinically silent and may represent an under-recognized contributor to postoperative acute kidney injury in patients undergoing minimally invasive urologic surgery. Recognition of risk factors associated with rhabdomyolysis is important in order to maintain an appropriate index of suspicion during the postoperative period. Further study is required to determine if treating subclinical rhabdomyolysis improves outcomes.

Funding

None