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:

Risk Factors

Factors that may increase your chance of muscle damage include:
  • Extreme exertion, such as running a marathon
  • Heat stroke
  • Use of some prescription drugs
  • Alcohol or drug abuse
  • Severe seizures or convulsions

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 and vomiting
In severe cases, rhabdomyolysis may result in:
  • Kidney damage or failure
  • Multi-organ failure
  • Abnormal heartbeat, also known as 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:
Your bodily fluids may be tested. This can be done with:
  • Urine tests
  • Blood tests
The activity of your muscles and heart may be tested. This can be done with:

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

Bicarbonate may be used to minimize myoglobin's toxic effects.

Dialysis

Dialysis is a procedure that uses a machine to filter blood when the kidneys are not functioning. The clean blood is then returned to your body.

Prevention

To reduce your chance of muscle damage and rhabdomyolysis:
  • Drink plenty of fluids when:
    • Exercising
    • Sitting or working in hot, humid weather
  • Drink alcohol in moderation—maximum of two drinks per day for men and one drink per day for women
  • Avoid illicit drugs

RESOURCES

Family Doctor—American Academy of Family Physicians
http://familydoctor.org
National Kidney Foundation
http://www.kidney.org

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca
The Kidney Foundation of Canada
http://www.kidney.ca

References

Rhabdomyolysis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 28, 2012. Accessed July 15, 2013.
Sauret JM, Marinides G, Wang GK. Rhabdomyolysis. Am Fam Physician. 2002:65(5):907-913.
Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: Pathogenesis, diagnosis, and treatment. Ochsner J. 2015;15(1):58-69.

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