What is rhabdomyolysis?

Rhabdomyolysis is a condition where injured muscles release harmful substances into the bloodstream. These substances include potassium, phosphate, creatinine kinase, and myoglobin. Large amounts of these substances may damage your kidneys and other organs.

What causes rhabdomyolysis?

  • Diseases: This includes conditions such as seizures, severe asthma, and infections. Excessive vomiting or diarrhea, diabetes, or problems of hyperthyroidism (thyroid storm) may also injure your muscles.

  • Temperature extremes: This includes hyperthermia (very high body temperature) or hypothermia (very low body temperature).

  • Extreme muscular activity: Extreme activity, such as running marathons, can cause muscle stress and injury.

  • Medicines or harmful substances: An overdose of aspirin or diuretics (water pills) may cause an electrolyte (mineral) imbalance and muscle injury. Antidepressants or medicine to lower cholesterol may also injure the muscles. Alcohol and illegal drugs such as amphetamines, opiates, ecstasy, and LSD can also cause muscle injury.

  • Trauma: Trauma to the muscles, such as a crushing injury, electrical shock, or severe burns, can cause rhabdomyolysis.

What are the signs and symptoms of rhabdomyolysis?

  • Pain, swelling, bruising, or weakness in your legs, arms, or lower back

  • Dark-colored urine, blood in the urine, or passing little or no urine at all

  • Fast heartbeat

  • Mental confusion or easy irritation

  • Nausea and vomiting

  • Trouble breathing

How is rhabdomyolysis diagnosed?

  • Blood tests: These check for the substances released by injured muscles. They may also be done to check your liver and kidney function.

  • Urine tests: This is done to check for blood in your urine, which may indicate kidney damage.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your muscles. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your muscles. An MRI may show muscle changes or injuries. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

  • Biopsy: Your caregiver will numb the affected area and remove a small piece of tissue from your muscle. The sample is sent to the lab for tests.

How is rhabdomyolysis treated?

  • IV hydration: Large amounts of IV fluid are given to help flush myoglobin and other substances through your kidneys. Other medicines may be added to the IV, such as:

    • Mannitol and diuretics: These can help your body get rid of fluid. They also help flush out harmful substances from your muscles that may collect in your kidneys.

    • Sodium bicarbonate: This helps reduce the acidity of your urine and the harmful effects of myoglobin to your kidneys.

  • Dialysis: Dialysis cleans your blood when your kidneys cannot. Extra water, chemicals, and waste products are removed from your blood by a dialyzer or dialysis machine. The dialysis machine does this by passing your blood through a special filter, then returning it back to you. Caregivers will check your vital signs often during dialysis. You may also be given medicines or have blood taken for lab tests during dialysis.

  • Blood transfusion: You will get whole or parts of blood through an IV during a transfusion. Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.

  • Surgery: You may need a surgery called fasciotomy. This is surgery to cut tissues that cover the muscles. This decreases pressure on blood vessels and nerves caused by swelling of the injured muscle.

What are the risks of rhabdomyolysis?

Even with treatment, you may have problems that include compartment syndrome, where there is increased pressure in a confined part in your body due to swelling or bleeding. You may also have kidney failure, bleeding disorders, or heart and lung conditions. If not treated, rhabdomyolysis may cause serious problems with electrolytes in your body. This can lead to heart and kidney problems and may be life-threatening.

When should I contact my caregiver?

Contact your caregiver if:

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your urine is dark or tea-colored or has blood in it.

  • You have pain, swelling, or weakness in your arms or legs that does not go away or gets worse.

  • You are urinating less than usual or not able to urinate.

  • You have chest pain.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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