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 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

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

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:

• Electromyography (EMG)
• Electrocardiogram (EKG)

Treatment

Treatment may include:

Prevention

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—maximum of two drinks per day for men and one drink per day for women
• Avoid illicit drugs

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

The Kidney Foundation of Canada http://www.kidney.ca

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.