Management of renal failure in earthquake-related crush syndrome: Multicenter intensive care outcomes
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Crush syndrome (CS) is a clinical condition associated with multisystem organ dysfunction that develops after traumatic rhabdomyolysis and primarily affects the kidneys. The aim of this study was to characterize the incidence, risk factors, and treatment patterns of acute kidney injury (AKI) in earthquake victims with CS, with a particular focus on renal replacement therapy (RRT) use and clinical outcomes. METHODS: In this retrospective multicenter study, 247 adult patients with earthquake-related CS who were admitted to intensive care units (ICUs) in 22 hospitals after the Kahramanmaraş 2023 earthquakes were analyzed. Demographic data, injury patterns, laboratory parameters, treatment protocols, and outcomes were evaluated during the first 15 days following ICU admission. RESULTS: AKI developed in 78.5% (n=194) of patients, and RRT was required in 62.4% (n=121) of those with AKI. Multiple logistic regression analysis demonstrated that myoglobin and creatinine levels were associated with an elevated risk of developing AKI (odds ratio [OR]: 1.001; 95% confidence interval CI: 1.000-1.001 and OR: 1.735; 95% CI: 1.151-2.615, respectively). Similarly, creatinine level and reasons for ICU admission were identified as factors influencing RRT administration. (OR: 1.7; 95% CI: 1.28-2.15 and OR: 2.9; 95% CI: 1.26-6.90, respectively). The 30-day mortality rate was higher in patients with AKI than in those without AKI. Mortality rates were similar between patients with AKI who received RRT and those who did not. CONCLUSION: This study demonstrates the high incidence of AKI in earthquake-related CS, underscores the need for improved disaster preparedness with adequate dialysis capacity and early risk stratification using serum myoglobin and creatinine levels for optimal management.
Authors: Zehra Hatipoğlu, Ömer Doğan, Mehmet Gökhan Gök, Kaniye Aydın, Ersel Güleç, Mediha Türktan, Ferhat Çetinkaya, Eda Macit Aydın, Busra Tezcan, Mehmet Murat Sayın, Ahu Akarca, Didem Sözütek Akkoyun, Devim Akdağ, Sinem Bayrakcı, Nazire Ateş Ayhan, İlhan Asude Akça, Gamze Koçak, Nihal Deniz Bulut Yüksel, Deniz Yüksel, Ahmet Coşar, Hatice Yağmurdur, Tülay Tuncer Peker, Nilgün Kavrut Öztürk, Vecihe Bayrak, Sedat Kaya, Aliye Esmaoğlu, Nuray Altay, Serhat Atılgan, Yeşim Şerife Bayraktar, Hilal Sipahioğlu, Kamuran Uluç, Yusuf Kemal Arslan, Dilek Özcengiz
Institutions: Cukurova University, Ministry of Health, Ankara Etlik City Hospital, Seyhan Devlet Hastanesi, Adana Hospital, Şanlıurfa Mehmet Akif İnan Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi, Antalya Eğitim ve Araştırma Hastanesi, Nevşehir Devlet Hastanesi, Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi, Erciyes University, Harran University, Selçuk University, Kayseri Eğitim ve Araştırma Hastanesi, Yedikule Teaching Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7220727996