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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    TOP

Rhabdomyolysis results from any condition that causes significant muscle damage. These include:

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
  • 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    TOP

You will be asked about your symptoms and medical history. A physical exam will be done.

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    TOP

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    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, humid 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
http://familydoctor.org
National Kidney Foundation
http://www.kidney.org

CANADIAN RESOURCES:

The Kidney Foundation of Canada
http://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 1, 2016.
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 2016 by Adrienne Carmack, MD
Last Updated: 5/11/2013

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