Rhabdomyolysis

Definition

Rhabdomyolysis is a group of symptoms. It caused by the breakdown of muscle tissue. Proteins called myoglobin are then released into the blood flow. These proteins can cause severe damage to the kidneys.

Causes    TOP

The muscle damage may be caused by:

  • Excessive muscle activity
  • Certain muscle diseases
  • Severe muscle injuries such as a crush injury
  • Overuse of alcohol or illicit drugs
  • Uncontrolled seizure disorder
  • Body is too cold—hypothermia
  • Body is too hot—heat stroke
  • Contact with electrical currentElectrical burns
  • Poison from a snake or spider bite
  • Major surgical procedures that need large, muscle incisions—rare

Risk Factors    TOP

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    TOP

The most common symptoms include:

  • Dark urine—brown or red in color (tea-colored)
  • Muscle pain
  • Muscle weakness

Other symptoms include:

  • Muscle swelling
  • Back pain
  • Nausea or vomiting

In severe cases, rhabdomyolysis may result in:

Anatomy of the Kidney

Glomerulonephritis
Copyright © Nucleus Medical Media, Inc.

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. The doctor may suspect rhabdo based on symptoms and recent past.

To confirm the diagnosis your may test:

  • Blood—to look for markers of muscle damage
  • Urine—to look for myoglobin, a protein released with muscle damage (only appears in urine if there are high levels in blood)

The activity of your muscles and heart may be tested. This can be done with:

  • Electromyography EMG
  • ECG—heart may be affected by electrolytes changes

Treatment    TOP

Treatment may include:

Hydration

Large amounts of fluid are the main treatment. The fluids are usually given by IV. This will help to quickly flush the myoglobin out of the kidneys. It can help the kidneys work well again.

Medication

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

Dialysis    TOP

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    TOP

To reduce your chance of muscle damage and rhabdomyolysis:

  • Drink plenty of fluids when:
    • Exercising
    • Sitting or working in hot weather
  • Drink alcohol in moderation—this is 2 drinks per day for men and 1 drink per day for women
  • Avoid illicit drugs

RESOURCES:

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

CANADIAN RESOURCES:

The Kidney Foundation of Canada
https://www.kidney.ca

References:

Rhabdomyolysis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114269/Rhabdomyolysis. Updated August 31, 2016. Accessed June 13, 2018.
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.
Last reviewed June 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/13/2018

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