Rhabdomyolysis is a condition that occurs when a large amount of muscle is damaged. When muscle fibers break down, they release substances into the bloodstream. One of these is a protein called myoglobin. Myoglobin can damage the kidneys. Other substances released by damaged muscles can cause chemical and fluid imbalance in the body. Because of the damage and imbalances, the kidneys stop working correctly. This can be dangerous, even fatal. Rhabdomyolysis is a medical emergency. Treatment is always done in the hospital.
What causes rhabdomyolysis?
Trauma (such as a car accident), especially crush injuries
Extended overexertion of the muscles (such as during marathon running)
Blockage of an artery or vein that leads to muscle death (such as deep vein thrombosis)
High-voltage electric shock (such as from lightning or power lines)
Abuse of alcohol
Use of certain illegal drugs
Taking certain prescription drugs, such as statins
Polymyositis, an inflammatory condition
Certain genetic disorders
Warning signs of rhabdomyolysis
Rhabdomyolysis is a medical emergency. If you have any of the following symptoms, go to the emergency room:
Dark, brownish or pinkish-red urine
Unusually stiff, achy, or tender muscles
Unusual muscle weakness
Other symptoms include fever, malaise, nausea, vomiting, and bruising.
As the condition worsens, other symptoms may occur. If you have any of these symptoms, go to the emergency room:
Swelling of the hands and feet
Treatment is always done in the hospital. An intravenous (IV) line is put into a vein in your arm or hand. IV fluids are then given to flush myoglobin and other harmful substances from the blood. Medicines may also be given to protect the kidneys. Other medicines are given to treat fluid and chemical imbalances and to help prevent complications. You may also be given pain medicine to control discomfort.
The hospital stay for rhabdomyolysis is several days or longer. During this time, you’re monitored to be sure no further problems develop. Your kidneys are checked for long-term damage. And the underlying cause of the condition is determined and treated if needed.
With early treatment, the kidneys often recover without long-term damage. In some cases, though, permanent kidney damage may have been done. If this is the case, your doctor will talk to you about any further treatment that is needed. And you and your doctor can discuss treating any underlying medical cause of the condition.
July 24, 2017
Clinical manifestations and diagnosis of rhabdomyolysis, Up To Date, Prevention and treatment of heme pigment-induced acute kidney injury (acute renal failure), Up To Date, Torres, Ochsner, J., Rhabdomyolysis: pathogenesis, diagnosis, and treatment (2015); 15; 1; pp 58-69
Fraser, Marianne, MSN, RN,Perez, Eric, MD