Rhabdomyolysis

  • Medical Author:
    Siamak N. Nabili, MD, MPH

    Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What are the complications of rhabdomyolysis?

One of the dreaded complications of rhabdomyolysis is kidney failure. This can occur for a variety of reasons. Direct injury to the kidney and plugging of the filtering tubes of the kidneys by the muscle proteins are among the causes of kidney function impairment in the setting of rhabdomyolysis.

Another serious complication of rhabdomyolysis is called the compartment syndrome where muscle injury leads to swelling and increased pressure in a confined space (a compartment). This leads to compromised circulation which can endanger the affected tissue. The compartment syndrome is most common after injury in the lower leg, arms, or the muscles of the abdominal wall and can require emergency surgery.

Rhabdomyolysis can also cause abnormality of electrolytes in the blood. Because of muscle injury, the contents of the muscle cells can be released into the blood causing high levels of potassium (hyperkalemia) and phosphorus (hyperphosphatemia).

How is rhabdomyolysis treated?

The treatment of rhabdomyolysis depends on its cause and severity.

If a cause for rhabdomyolysis is identified, it is addressed; for example:

  • discontinuing a toxic medication,
  • replacing electrolytes, or
  • treating an underlying muscle disease.

In cases of mild rhabdomyolysis without any evidence of complications, management can take place at home by simply recognizing the cause and correcting it, such as discontinuing a medication and rehydration.

In more severe cases, or if home therapy is not possible, hospitalization may be required. Prompt initiation of hydration with intravenous fluids, in addition to the removal the provoking factor(s), is an essential part of the treatment of rhabdomyolysis. Monitoring and managing kidney dysfunction, correcting any disturbance in the electrolytes, and monitoring the muscle enzyme levels (CPK, SGOT, SGPT, LDH) are most effectively done in the hospital when rhabdomyolysis is severe.

Medically Reviewed by a Doctor on 2/9/2015

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