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by Alan R

Rhabdomyolysis

Definition

Rhabdomyolysis occurs when skeletal muscles are damaged and release myoglobin into the bloodstream. Myoglobin is an iron-containing pigment that can cause severe damage to the kidneys.

Causes

Rhabdomyolysis results from any condition that causes significant muscle damage. These include:
  • Certain muscle diseases
  • Severe muscle injuries (such as a crush injury)
  • Overuse of alcohol or illicit drugs
  • Use of some prescription drugs
  • Severe seizures or convulsions
  • Extensive surgical procedures using large, muscle-dividing incisions (rare)

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Factors that may increase the risk of muscle damage include:
  • Extreme exertion (such as running a marathon)
  • Heat stroke
  • Alcohol or drug abuse
  • Uncontrolled seizure disorder

Symptoms

The most common symptoms include:
  • Dark urine (brown or red in color)
  • Muscle pain
  • Muscle weakness
Other symptoms include:
  • Muscle swelling
  • Back pain
  • Nausea
  • Vomiting
In severe cases, rhabdomyolysis may result in:
  • Kidney damage or failure due to blocked arterial blood flow
  • Multi-organ failure
  • Abnormal heartbeat (arrhythmia)
Anatomy of the Kidney
Glomerulonephritis
Copyright © Nucleus Medical Media, Inc.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

Treatment

Treatment may include:

Hydration

Giving large amounts of fluid is the main treatment. Fluids are usually given by IV. Hydration helps to quickly flush myoglobin out of the kidneys to restore their function.

Medication

Medication may include:
  • Diuretics—to help flush out the kidneys
  • Bicarbonate—to minimize myoglobin's toxic effects

Dialysis

Dialysis is a procedure that uses an artificial kidney machine to filter blood. The clean blood is then returned to your body.

Prevention

Steps for prevention include:
  • Drink plenty of fluids when:
    • Exercising
    • Sitting or working in hot, humid weather
  • Avoid overuse of alcohol
  • Avoid illicit drugs

RESOURCES

National Institute of Health, US National Library of Medicine http://www.nlm.nih.gov

National Kidney Foundation http://www.kidney.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca/index-eng.php

The Kidney Foundation of Canada: British Columbia Branch http://www.kidney.ca

References

Criddle L. Rhabdomyolysis. Crit Care Nurse. 2003 Dec 23(6):14-30.

Rhabdomyolysis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com. Updated January 26, 2011. Accessed October 17, 2012.

Sauret J, Marinides G. Rhabdomyolysis. Am Fam Physician. 2002 Mar 1:65(5):907-913.

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