Pediatric rhabdomyolysis: a systematic review and meta-analysis of etiologies, management, and outcomes
Bibliographic record
Abstract
Abstract Background 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. Methods 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. Results 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 2 = 0%), respectively. The pooled mortality rate of children with rhabdomyolysis was 4.5% (95% CI: 1.7 to 11.8; I 2 = 94.7%). Conclusions 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. Systematic review protocol registration PROSPERO: CRD420251035968.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.012 | 0.003 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".