Role of creatine phosphokinase in predicting acute renal failure in hypocalcemic exertional heat stroke

Shang Der Shieh, Yuh Feng Lin, Kuo Cheng Lu, Bi Lian Li, Pauling Chu, Tai Pin Shyh, Liang Kuang Diang

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Recruits frequently develop hypocalcemia in exertional heat stroke (ExHS) with rhabdomyolysis and acute renal failure (ARF) from intensive training. It usually indicated severe skeletal muscle damage. However, the relative risk of ARF in ExHS patients complicated with hypocalcemia was unknown. The present study was undertaken to evaluate the value of peak serum creatine phosphokinase (CPK) level in predicting ARF in ExHS patients with hypocalcemia. Sixty-eight army recruits with ExHS were hospitalized at the Tri-Service General Hospital, Taiwan: 17 with ARF and hypocalcemia (group A); 7 with ARF but without hypocalcemia (group B); 20 without ARF but with hypocalcemia (group C); and 24 without ARF or hypocalcemia (group D). In the 24 patients with ARF (groups A and B) the serum phosphate and peak CPK levels were significantly higher than in patients without ARF (groups C and D; p <0.001), serum calcium levels were also significantly lower in the former (p <0.001). In the 37 patients with hypocalcemia (groups A and C), the peak serum CPK levels were significantly higher than in those without hypocalcemia (groups B and D; p <0.001). There was a higher proportion of hypocalcemic patients with peak serum CPK levels greater than 10, 000 U/l among ARF compared with patients without ARF (χ2 = 12.48, p <0.001). In 24 patients with ARF, there was a negative correlation between serum Ca and peak CPK levels (t = 3.37, r = -0.58, p <0.01). However, a positive correlation was found between serum creatinine and peak serum CPK levels in 37 patients with hypocalcemia (t = 2.47, r = 0.39, p <0.02). In conclusion, hypocalcemia was found in 37/68 (54.4%) of ExHS patients. Peak serum CPK over 10, 000 U/l increases the tendency of developing ARF; furthermore, it is unequivocally useful in predicting ARF in hypocalcemic ExHS patients.

Original languageEnglish
Pages (from-to)252-258
Number of pages7
JournalAmerican Journal of Nephrology
Volume12
Issue number4
DOIs
Publication statusPublished - 1992
Externally publishedYes

Fingerprint

Heat Stroke
Creatine Kinase
Acute Kidney Injury
Hypocalcemia
Serum
Rhabdomyolysis
Taiwan

Keywords

  • Acute renal failure
  • Creatine phosphokinase
  • Hypocalcemic exertional heat stroke
  • Rhabdomyolysis

ASJC Scopus subject areas

  • Nephrology

Cite this

Role of creatine phosphokinase in predicting acute renal failure in hypocalcemic exertional heat stroke. / Shieh, Shang Der; Lin, Yuh Feng; Lu, Kuo Cheng; Li, Bi Lian; Chu, Pauling; Shyh, Tai Pin; Diang, Liang Kuang.

In: American Journal of Nephrology, Vol. 12, No. 4, 1992, p. 252-258.

Research output: Contribution to journalArticle

Shieh, Shang Der ; Lin, Yuh Feng ; Lu, Kuo Cheng ; Li, Bi Lian ; Chu, Pauling ; Shyh, Tai Pin ; Diang, Liang Kuang. / Role of creatine phosphokinase in predicting acute renal failure in hypocalcemic exertional heat stroke. In: American Journal of Nephrology. 1992 ; Vol. 12, No. 4. pp. 252-258.
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abstract = "Recruits frequently develop hypocalcemia in exertional heat stroke (ExHS) with rhabdomyolysis and acute renal failure (ARF) from intensive training. It usually indicated severe skeletal muscle damage. However, the relative risk of ARF in ExHS patients complicated with hypocalcemia was unknown. The present study was undertaken to evaluate the value of peak serum creatine phosphokinase (CPK) level in predicting ARF in ExHS patients with hypocalcemia. Sixty-eight army recruits with ExHS were hospitalized at the Tri-Service General Hospital, Taiwan: 17 with ARF and hypocalcemia (group A); 7 with ARF but without hypocalcemia (group B); 20 without ARF but with hypocalcemia (group C); and 24 without ARF or hypocalcemia (group D). In the 24 patients with ARF (groups A and B) the serum phosphate and peak CPK levels were significantly higher than in patients without ARF (groups C and D; p <0.001), serum calcium levels were also significantly lower in the former (p <0.001). In the 37 patients with hypocalcemia (groups A and C), the peak serum CPK levels were significantly higher than in those without hypocalcemia (groups B and D; p <0.001). There was a higher proportion of hypocalcemic patients with peak serum CPK levels greater than 10, 000 U/l among ARF compared with patients without ARF (χ2 = 12.48, p <0.001). In 24 patients with ARF, there was a negative correlation between serum Ca and peak CPK levels (t = 3.37, r = -0.58, p <0.01). However, a positive correlation was found between serum creatinine and peak serum CPK levels in 37 patients with hypocalcemia (t = 2.47, r = 0.39, p <0.02). In conclusion, hypocalcemia was found in 37/68 (54.4{\%}) of ExHS patients. Peak serum CPK over 10, 000 U/l increases the tendency of developing ARF; furthermore, it is unequivocally useful in predicting ARF in hypocalcemic ExHS patients.",
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AU - Shieh, Shang Der

AU - Lin, Yuh Feng

AU - Lu, Kuo Cheng

AU - Li, Bi Lian

AU - Chu, Pauling

AU - Shyh, Tai Pin

AU - Diang, Liang Kuang

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