Can creatine kinase levels be an indicator of the need for hemodialysis?

Abstract

Introduction/Objective This study aimed to evaluate the relationship between changes in creatine kinase (CK) levels and the need for dialysis in patients with crush syndrome (CS).

Methods We conducted a retrospective analysis of patients with CS who were admitted to our hospital after the earthquake from February to May of 2023. We recorded demographic and laboratory data of the patients and divided them into two groups based on the change in CK levels within 48 hours. The groups were compared based on the need for dialysis and mortality rates.

Results A total of 84 patients with crush injuries participated in the study (41 males and 43 females). The average age was 33.65 ± 13.1 years. Nineteen patients received hemodialysis, and 18 patients underwent fasciotomy due to compartment syndrome. The patients were divided into two groups, Group 1 consisted of patients with more than a 50% decrease in CK levels within 48 hours, while Group 2 included patients with a decrease of less than 50% in CK levels during the same period. We compared the two groups regarding the frequency of dialysis and mortality. No statistically significant differences were found between the groups (p = 0.328 for dialysis and p = 0.89 for mortality).

Conclusion Although CK is an important enzyme for diagnosing CS and indicates ongoing muscle damage, changes in CK levels during follow-up do not reliably predict the need for dialysis or mortality risk.

Keywords: crush syndrome; creatine kinase; dialysis; mortality