Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes

<h3 dir="ltr">Background</h3><p dir="ltr">Rhabdomyolysis is a potentially fatal disorder that occurs due to various causes. Therefore, the aim of this meta-analysis was to identify the underlying causes, evaluate the treatment options, and determine the mortalit...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Hany A. Zaki (17337673) (author)
مؤلفون آخرون: Hussam Elmelliti (17347060) (author), Waseem Ahmad Malik (22508645) (author), Eman E. Shaban (17337676) (author), Amira Shaban (21797471) (author), Ahmed Shaban (5860202) (author)
منشور في: 2025
الموضوعات:
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author Hany A. Zaki (17337673)
author2 Hussam Elmelliti (17347060)
Waseem Ahmad Malik (22508645)
Eman E. Shaban (17337676)
Amira Shaban (21797471)
Ahmed Shaban (5860202)
author2_role author
author
author
author
author
author_facet Hany A. Zaki (17337673)
Hussam Elmelliti (17347060)
Waseem Ahmad Malik (22508645)
Eman E. Shaban (17337676)
Amira Shaban (21797471)
Ahmed Shaban (5860202)
author_role author
dc.creator.none.fl_str_mv Hany A. Zaki (17337673)
Hussam Elmelliti (17347060)
Waseem Ahmad Malik (22508645)
Eman E. Shaban (17337676)
Amira Shaban (21797471)
Ahmed Shaban (5860202)
dc.date.none.fl_str_mv 2025-10-27T09:00:00Z
dc.identifier.none.fl_str_mv 10.1186/s12887-025-06081-x
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Pediatric_rhabdomyolysis_a_systematic_review_and_meta-analysis_of_etiologies_management_and_outcomes/31167952
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Paediatrics
Rhabdomyolysis
Pediatric patients
Chronic kidney disease
Acute kidney injury
dc.title.none.fl_str_mv Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3 dir="ltr">Background</h3><p dir="ltr">Rhabdomyolysis is a potentially fatal disorder that occurs due to various causes. Therefore, the aim of this meta-analysis was to identify the underlying causes, evaluate the treatment options, and determine the mortality and kidney outcomes of children with rhabdomyolysis.</p><h3 dir="ltr">Methods</h3><p dir="ltr">We comprehensively searched PubMed, Cochrane Library, Web of Science, EMBASE, and Google Scholar databases for records written in English and published until April 2025. According to PICO criteria, we included studies that enrolled pediatric patients with rhabdomyolysis and reported etiologies, treatments, mortality, and/or kidney outcomes. Subsequently, quality appraisal was conducted with Newcastle Ottawa Scale and statistical analyses were performed using comprehensive meta-analysis (CMA) software.</p><h3 dir="ltr">Results</h3><p dir="ltr">Fifteen studies enrolling 10,514 pediatric patients with rhabdomyolysis were reviewed and analyzed. The one-arm meta-analysis revealed that infections were the most predominant etiology of rhabdomyolysis (40.6%; 95% CI: 33.5 to 48.2), followed by trauma (19%; 95% CI: 15.5 to 23.0) and exercise (14.7%; 95% CI: 6.5 to 30.2). Other etiologies accounted for less than 10% of rhabdomyolysis cases i.e., burns (2.9%; 95% CI: 1.2 to 7.2), connective tissue disorder (2.7%; 95% CI: 0.7 to 9.6), drugs (5.8%; 95% CI: 3.1 to 10.6), metabolic abnormalities (4.4%; 95% CI: 3.0 to 6.6), multiorgan failure (4.1%; 95% CI: 1.0 to 15.5), muscular dystrophy (2.6%; 95% CI: 0.6 to 11.4), seizure (7.2%; 95% CI: 3.9 to 12.9), and sepsis (9.9%; 95% CI: 1.1 to 52.8). The pooled results also showed that the incidences of acute kidney injury (AKI) and chronic kidney disease (CKD) were 21.3% (95% CI: 14.5 to 30.3; I 2 = 96%) and 1.1% (95% CI: 0.7 to 2; I<sup>2</sup> = 0%), respectively. The pooled mortality rate of children with rhabdomyolysis was 4.5% (95% CI: 1.7 to 11.8; I<sup>2</sup> = 94.7%).</p><h3 dir="ltr">Conclusions</h3><p dir="ltr">Infections are the leading causes of rhabdomyolysis in children. Moreover, AKI is a common complication of rhabdomyolysis in children. However, the prognosis of children with rhabdomyolysis is good and few patients progress to CKD.</p><h3 dir="ltr">Systematic review protocol registration</h3><p dir="ltr">PROSPERO: CRD420251035968.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: BMC Pediatrics<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12887-025-06081-x" target="_blank">https://dx.doi.org/10.1186/s12887-025-06081-x</a></p>
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spelling Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomesHany A. Zaki (17337673)Hussam Elmelliti (17347060)Waseem Ahmad Malik (22508645)Eman E. Shaban (17337676)Amira Shaban (21797471)Ahmed Shaban (5860202)Biomedical and clinical sciencesClinical sciencesPaediatricsRhabdomyolysisPediatric patientsChronic kidney diseaseAcute kidney injury<h3 dir="ltr">Background</h3><p dir="ltr">Rhabdomyolysis is a potentially fatal disorder that occurs due to various causes. Therefore, the aim of this meta-analysis was to identify the underlying causes, evaluate the treatment options, and determine the mortality and kidney outcomes of children with rhabdomyolysis.</p><h3 dir="ltr">Methods</h3><p dir="ltr">We comprehensively searched PubMed, Cochrane Library, Web of Science, EMBASE, and Google Scholar databases for records written in English and published until April 2025. According to PICO criteria, we included studies that enrolled pediatric patients with rhabdomyolysis and reported etiologies, treatments, mortality, and/or kidney outcomes. Subsequently, quality appraisal was conducted with Newcastle Ottawa Scale and statistical analyses were performed using comprehensive meta-analysis (CMA) software.</p><h3 dir="ltr">Results</h3><p dir="ltr">Fifteen studies enrolling 10,514 pediatric patients with rhabdomyolysis were reviewed and analyzed. The one-arm meta-analysis revealed that infections were the most predominant etiology of rhabdomyolysis (40.6%; 95% CI: 33.5 to 48.2), followed by trauma (19%; 95% CI: 15.5 to 23.0) and exercise (14.7%; 95% CI: 6.5 to 30.2). Other etiologies accounted for less than 10% of rhabdomyolysis cases i.e., burns (2.9%; 95% CI: 1.2 to 7.2), connective tissue disorder (2.7%; 95% CI: 0.7 to 9.6), drugs (5.8%; 95% CI: 3.1 to 10.6), metabolic abnormalities (4.4%; 95% CI: 3.0 to 6.6), multiorgan failure (4.1%; 95% CI: 1.0 to 15.5), muscular dystrophy (2.6%; 95% CI: 0.6 to 11.4), seizure (7.2%; 95% CI: 3.9 to 12.9), and sepsis (9.9%; 95% CI: 1.1 to 52.8). The pooled results also showed that the incidences of acute kidney injury (AKI) and chronic kidney disease (CKD) were 21.3% (95% CI: 14.5 to 30.3; I 2 = 96%) and 1.1% (95% CI: 0.7 to 2; I<sup>2</sup> = 0%), respectively. The pooled mortality rate of children with rhabdomyolysis was 4.5% (95% CI: 1.7 to 11.8; I<sup>2</sup> = 94.7%).</p><h3 dir="ltr">Conclusions</h3><p dir="ltr">Infections are the leading causes of rhabdomyolysis in children. Moreover, AKI is a common complication of rhabdomyolysis in children. However, the prognosis of children with rhabdomyolysis is good and few patients progress to CKD.</p><h3 dir="ltr">Systematic review protocol registration</h3><p dir="ltr">PROSPERO: CRD420251035968.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: BMC Pediatrics<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12887-025-06081-x" target="_blank">https://dx.doi.org/10.1186/s12887-025-06081-x</a></p>2025-10-27T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12887-025-06081-xhttps://figshare.com/articles/journal_contribution/Pediatric_rhabdomyolysis_a_systematic_review_and_meta-analysis_of_etiologies_management_and_outcomes/31167952CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/311679522025-10-27T09:00:00Z
spellingShingle Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
Hany A. Zaki (17337673)
Biomedical and clinical sciences
Clinical sciences
Paediatrics
Rhabdomyolysis
Pediatric patients
Chronic kidney disease
Acute kidney injury
status_str publishedVersion
title Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
title_full Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
title_fullStr Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
title_full_unstemmed Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
title_short Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
title_sort Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
topic Biomedical and clinical sciences
Clinical sciences
Paediatrics
Rhabdomyolysis
Pediatric patients
Chronic kidney disease
Acute kidney injury