Nephrology Book

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McMahon Rhabdomyolysis Score

Aka: McMahon Rhabdomyolysis Score, McMahon Score
  1. See Also
    1. Rhabdomyolysis
  2. Indications
    1. Predicts Rhabdomyolysis associated Renal Failure
  3. Criteria: Assumes Rhabdomyolysis with initial CPK >1000 (or 5 times normal)
    1. Age
      1. Score 0: <=50 years old
      2. Score 1.5: 51-70 years old
      3. Score 2.5: 71-80 years old
      4. Score 3: >80 years old
    2. Gender
      1. Score 0: Male
      2. Score 1: Female
    3. Initial Serum Creatinine
      1. Score 0: <1.4 mg/dl (<125 µmol/L)
      2. Score 1.5: 1.4 to 2.2 (125-195 µmol/L)
      3. Score 3: >2.2 mg/dl (>195 µmol/L)
    4. Initial Serum Calcium <7.5 mg/dL (1.88 mmol/L)
      1. Score 0: No
      2. Score 2: Yes
    5. Initial Creatine Phosphokinase (CK) >40,000
      1. Score 0: No
      2. Score 2: Yes
    6. Caused by Seizure, Syncope, Exercise, Statin or Myositis
      1. Score 0: Yes
      2. Score 3: No
    7. Initial Phosphate
      1. Score 0: <4 mg/dl (<1 mmol/L)
      2. Score 1.5: 4 to 5.4 mg/dl (1-1.4 mmol/L)
      3. Score 3: >5.4 mg/dl (>1.4 mmol/L)
    8. Initial Serum Bicarbonate <19 mEq/L (<19 mmol/L)
      1. Score 0: No
      2. Score 2: Yes
  4. Interpretation
    1. Score <6: Low risk of serious adverse outcomes
      1. Risk <3% for death or Acute Kidney Injury requiring renal replacement therapy
    2. Score >=6: Not Low Risk
      1. Increased risk of serious adverse outcomes (Test Sensitivity 83%)
  5. Resources
    1. MD Calc
      1. https://www.mdcalc.com/mcmahon-score-rhabdomyolysis
    2. QxMD
      1. https://qxmd.com/calculate/calculator_587/mcmahon-rhabdomyolysis-risk-score
  6. References
    1. McMahon (2013) JAMA Intern Med 173(19):1821-8

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