Rhabdomyolysis

by Rick Alan

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

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 current Electrical burns
Poison from a snake or spider bite
Major surgical procedures that need large, muscle incisions—rare

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 (tea-colored)
Muscle pain
Muscle weakness

Other symptoms include:

Muscle swelling
Back pain
Nausea or vomiting

In severe cases, rhabdomyolysis may result in:

Kidney damage or failure
Multiple organ failure
Abnormal heartbeat, also known as arrhythmia

Anatomy of the Kidney

Diagnosis

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

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

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 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:

Health Canada
https://www.canada.ca

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 May 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/13/2018

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