RHABDOMYOLYSIS: CPK IS NOT A MARKER

Introduction: Rhabdomyolysis is a syndrome characterized by the injury of skeletal muscle cells, releasing their components into the bloodstream. In the USA, there are about 26 thousand cases annually, of which 5 to 25% evolve to acute kidney injury. Causes include trauma, ischemia, drugs, and intense physical exercise. The most common diagnosis is made by serum creatine phosphokinase (CPK) dosage. Objective: To dissociate serum CPK levels from the isolated diagnosis of rhabdomyolysis. Materials and Methods: This study is a systematic review of articles on exercise-induced rhabdomyolysis, following PRISMA. The databases used were Scopus, Embase, Web of Science and Pubmed. The keywords were “exertional rhabdomyolysis” and “exercise induced rhabdomyolysis”. Of the 2600 articles found, those relating CPK to complications of exercise-induced rhabdomyolysis were maintained. Articles on other etiologies of rhabdomyolysis and the pediatric population were excluded. The remaining articles were classified by the Oxford Levels of Evidence, excluding case reports, expert opinions, and non-full-text articles, resulting in 8 articles that related exercise-induced rhabdomyolysis and serum CPK levels to the onset of symptoms and target organ damage. Results: The review included 8 articles, totaling 66 clinical cases. All patients had elevated serum CPK levels and were diagnosed with rhabdomyolysis. The 66 patients were divided into 4 main groups according to their clinical status, tests requested, and evolution. Conclusion: The CPK increases after the practice of physical activity and remains elevated in trained individuals. Patients who developed complications had risk factors. The diagnosis of rhabdomyolysis should be based on serum CPK, serum myoglobin, and urine myoglobin