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Rhabdomyolysis

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Condition Detail

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

Diagnosis

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

Urine tests
Blood tests
Muscle testing (electromyography)

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.

Revision Information

Reviewer: Adrienne Carmack, MD
Review Date: 10/2012 -
Update Date: 10/31/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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