#6665 NON TRAUMATIC RHABDOMYOLYSIS AND ACUTE RENAL FAILURE: WHICH INDICATIONS OF RENAL REPLACEMENT THERAPY?

Abstract Background and Aims The aim of our study is to identify the causes non-traumatic rhabdomyolysis in context, clinical biological presentation patients indications renal replacement therapy management this entity. Method Our a monocentric retrospective conducted at universitary hospital Mohamed VI Marrakech including 14 who presented complicated by acute kidney inury (AKI) with no traumatic context. Those were followed up intensive care unit nephrology department over period 10 months from March December 2022. Results age varied between 24 64 years for an average 42 years. male sex was predominant (78.57%) 11 men versus 3 women history previous disease. stay 20 days [12-42 days]. most common signs oligo-anuria (85.7%), abdominal pain (57.1%), nausea vomiting (42.8%), flank (42.8%) muscle (14.2%), hypertension 5 (35.7%), while 4 hypotensive. creatinine on admission 22mg/l [14-42.3], CPK level 6240UI/L [2225-12570], myoglobin assayed single patient which returned positive 6230 mg/l. mean serum potassium 5.6mmol/l [4.2-8.1], phosphorus 45mg/l [32-72mg/l], calcium 81.2mg/l [68- 91] bicarbonate 12 mmol/l [4-22]. etiologies rhabdmyolysis series as follows: In cases related prolonged immobilization, it occurred postoperative context (post-vascular surgery femoro-popliteal bypass ilio-popliteal 2 orthopedic bone tumor tibia one case), severe sepsis. cases, status epilepticus, neuroleptic malignant syndrome case post-IdM. Management based hemodynamic respiratory support through restoration blood volume intravenous (100% patients) oral (83.3%) rehydration, use vasoactive drugs correction metabolic disorders essentially hyperkalaemia acidosis etiological treatment causal condition. RRT (Renal therapy) indicated total patients: anuria > hours threatening hyperkalaemia. modalities technique used daily IHD (intermittent hemodialysis) lasting 1h30 4h. number hemodialysis sessions 3.6 (minimum maximum 5). evolution Among 9 not dialysis, 6 recovered normal function, maintained IR discharge (creatinine 13 19 mg/l respectively) died septic shock. two good function recovery diuresis, remained failure, due multiple organ failure. Conclusion non above all rehydration order establish eliminate pigment. necesseray some such sever hyperkalaemia, or persistent anuria. Several studies suggest benefit its early initiation, still remains be demonstrated.