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

    Rhabdomyolysis results from any condition that causes significant muscle damage. These include:
    • Excessive muscle activity
    • Certain muscle diseases
    • Severe muscle injuries, such as a crush injury
    • Overuse of alcohol or illicit drugs
    • Uncontrolled seizure disorder
    • Hypothermia
    • Contact with an electrical current
    • Toxins, such as snake or spider venom
    • Extensive surgical procedures using large, muscle-dividing incisions—rare
  • Risk Factors

    Factors that may increase the risk 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
    • 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
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  • Diagnosis

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

    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
    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

    American Academy of Family Physicians http://familydoctor.org

    National Kidney Foundation http://www.kidney.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    The Kidney Foundation of Canada 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 October 28, 2012. Accessed July 15, 2013.

    Sauret J, Marinides G. Rhabdomyolysis. Am Fam Physician . 2002 Mar 1:65(5):907-913.

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