Creatinine Kinase - CK

Causes of a Raised CK

• Skeletal muscle – excessive exercise, rhabdomyolysis, myositis, fall with long lie, seizure, intramuscular injection, surgery
• Cardiac muscle damage – ACS, myocarditis
• Drugs: statin, fibrate, antiretrovirals, B.blockers, clozapine, ACEi, isotretenoin, colchicine
• Endocrine disorder:  hypothyroidism, hyperparathyroidism, cushing’s, acromegaly, DKA
• AKI
• Malignancy
• Pregnancy

Investigation

• Urine dip for Hb (myoglobulin), U&E (AKI), troponin (cardiac cause)
• NBT have this guidance that you may find helpful

Management

• Rehydration (oral or IV)
• Consider discussion with medical consultant
• Repeat CK to check trend
• Consider d/w rheumatology if muscle disease suspected