Archives of academic emergency medicine · 2026
The Value of Serum CK in Predicting Traumatic Rhabdomyolysis Induced Acute Kidney Injury: A Systematic Review and Meta-Analysis.
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Ahmadzadeh Koohyar, Roshdi Dizaji Shayan, Dasdar Shayan, Kianfar Nika, Sajjadi Seyed Mohamad, Najafi Iraj, Yousefifard Mahmoud, Safari Saeed
Аннотация
INTRODUCTION: Creatine kinase (CK) has frequently been introduced as a predictive factor of rhabdomyolysis induced acute kidney injury (AKI) in several studies. However, its value, especially in traumatic and disaster settings, remains to be fully clarified.
METHODS: Online databases of Medline (via PubMed), Embase, Scopus, and Web of Science were systematically searched until May 15th, 2026 and studies evaluating the association between serum CK and AKI in traumatic rhabdomyolysis patients were included. Reports of CK were collected as mean differences between the AKI and non-AKI groups, odds ratios (ORs), and performance metrics such as sensitivity and specificity. Analyses were performed using STATA 17.0 statistical software. The study's protocol has been registered with PROSPERO (CRD420251250906).
RESULTS: 17 articles were included in this study. Twelve studies encompassing 3122 rhabdomyolysis patients (AKI: 30.94%) evaluated mean CK values in AKI and non-AKI patients with a pooled mean difference of 21770.75 (95% CI: 8987.39 to 34554.11) IU/L between groups. Four studies of 3549 patients (AKI: 20.29%) reported a pooled adjusted OR of 7.62 (95% CI 2.80 to 20.76). Ten articles, including 3421 patients (AKI: 18.42%), reported prediction accuracy measures. The pooled analysis showed an AUC of 0.73 (95% CI: 0.69 to 0.77), with sensitivity 0.68 (95% CI: 0.55 to 0.78) and specificity of 0.68 (95% CI: 0.54 to 0.78).
CONCLUSION: Our findings indicate that, across traumatic rhabdomyolysis populations, AKI was associated with higher CK levels, with a more pronounced elevation observed in earthquake-related settings, although heterogeneity was high. CK alone demonstrated only fair discriminatory performance, suggesting its use as part of a broader clinical risk assessment rather than as a sole predictor of AKI.
METHODS: Online databases of Medline (via PubMed), Embase, Scopus, and Web of Science were systematically searched until May 15th, 2026 and studies evaluating the association between serum CK and AKI in traumatic rhabdomyolysis patients were included. Reports of CK were collected as mean differences between the AKI and non-AKI groups, odds ratios (ORs), and performance metrics such as sensitivity and specificity. Analyses were performed using STATA 17.0 statistical software. The study's protocol has been registered with PROSPERO (CRD420251250906).
RESULTS: 17 articles were included in this study. Twelve studies encompassing 3122 rhabdomyolysis patients (AKI: 30.94%) evaluated mean CK values in AKI and non-AKI patients with a pooled mean difference of 21770.75 (95% CI: 8987.39 to 34554.11) IU/L between groups. Four studies of 3549 patients (AKI: 20.29%) reported a pooled adjusted OR of 7.62 (95% CI 2.80 to 20.76). Ten articles, including 3421 patients (AKI: 18.42%), reported prediction accuracy measures. The pooled analysis showed an AUC of 0.73 (95% CI: 0.69 to 0.77), with sensitivity 0.68 (95% CI: 0.55 to 0.78) and specificity of 0.68 (95% CI: 0.54 to 0.78).
CONCLUSION: Our findings indicate that, across traumatic rhabdomyolysis populations, AKI was associated with higher CK levels, with a more pronounced elevation observed in earthquake-related settings, although heterogeneity was high. CK alone demonstrated only fair discriminatory performance, suggesting its use as part of a broader clinical risk assessment rather than as a sole predictor of AKI.