How often CK levels or myoglobin levels needs to be checked in rhabdomyolysis?
CK levels are the most sensitive marker of muscle injury. Normal CK levels can go as high as 400 U/L. In muscle injury, CK levels tend to rise in the first 12 hours and peak in 1 to 3 days, with levels remaining elevated for up to 5 days after resolution of the muscle injury.
CK levels correlate with the degree of muscle injury and may correlate with the risk of AKI. The risk of developing AKI is usually low when the CK level is below 10,000 U/L.
Persons who develop AKI at lower levels of CK often have coexisting conditions predisposing them to AKI, such as sepsis, hypotension, or underlying chronic kidney disease.
Myoglobin levels rise rapidly (within 3 hours) and serum levels peak prior to serum CK levels.
Myoglobin has a short half-life of 2 to 3 hours and is rapidly excreted by the kidneys.
Rapid and unpredictable metabolism makes serum myoglobin a less useful marker of muscle injury than CK, and is rarely used in assessing the risk of AKI.