Published: 18 Jun 2025

ICD9: 728.88      ICD10: M62.82      ICD11: FB32.20

Rhabdomyolysis (often shortened to "rhabdo") is a serious condition that occurs when damaged muscle tissue breaks down rapidly.
This breakdown releases muscle cell contents into the bloodstream, including:

Myoglobin: A protein that stores oxygen in muscle cells.
Creatine kinase (CK): An enzyme found in muscle tissue.
Electrolytes: Such as potassium, phosphorus, and calcium.

These released substances can overwhelm the kidneys and other organs, leading to potentially life-threatening complications.

Here's a breakdown of the key aspects:

Cause: Muscle damage is the primary cause. Common causes include:
Extreme exercise: Especially in untrained individuals or those pushing themselves too hard.
Trauma: Crush injuries, burns, electrical shock.
Medications: Certain statins, antipsychotics, and other drugs can cause rhabdo as a side effect.
Drug and alcohol abuse: Especially cocaine, amphetamines, and alcohol.
Infections: Viral or bacterial infections.
Metabolic disorders: Genetic conditions affecting muscle metabolism.
Prolonged immobilization: Being unable to move for a long time (e.g., after a stroke or surgery).
Extreme body temperature: Hyperthermia (heatstroke) or hypothermia.
Symptoms: Symptoms can vary from mild to severe. Common signs and symptoms include:
Muscle pain, tenderness, or weakness: Often in the shoulders, thighs, or lower back.
Dark, reddish-brown urine: Due to the presence of myoglobin. This is a very important sign to look out for.
Muscle swelling.
Fatigue.
General malaise (feeling unwell).
Nausea and vomiting.
Abdominal pain.
Rapid heart rate.
Fever.
Confusion or altered mental status.
Decreased urination. This can be a sign of kidney damage.

It is important to note that some people with rhabdomyolysis may not experience any symptoms.*

Diagnosis: Diagnosis is usually made based on:
Blood tests: Measuring levels of creatine kinase (CK), which will be significantly elevated (often 5-10 times the upper limit of normal, or even higher). Also, kidney function tests (BUN, creatinine) will be assessed.
Urine tests: Checking for myoglobin.
Complications: If left untreated, rhabdomyolysis can lead to:
Kidney failure (acute renal failure): Myoglobin can damage the kidneys. This is the most serious complication.
Electrolyte imbalances: Particularly hyperkalemia (high potassium), which can cause cardiac arrhythmias.
Compartment syndrome: Swelling in muscles can cut off blood supply to the tissues.
Disseminated intravascular coagulation (DIC): A life-threatening condition affecting blood clotting.
Death.
Treatment: The main goal of treatment is to prevent kidney failure and other complications. Treatment typically involves:
Aggressive intravenous (IV) fluid hydration: To flush myoglobin from the kidneys and protect them.
Electrolyte management: To correct any imbalances.
Dialysis: May be necessary if kidney failure develops.
Treating the underlying cause: For example, stopping a medication that is causing the problem.
Bicarbonate: to alkalinize the urine, which helps prevent myoglobin from precipitating in the kidneys.
Monitoring: Careful monitoring of kidney function, electrolytes, and cardiac rhythm.
Prevention:
Stay hydrated: Drink plenty of fluids, especially during and after exercise.
Avoid overexertion: Gradually increase the intensity and duration of exercise.
Be aware of medications: Know the potential side effects of any medications you are taking.
Seek medical attention: If you experience muscle pain, weakness, or dark urine, especially after strenuous exercise or trauma, see a doctor immediately.

In summary, rhabdomyolysis is a serious condition resulting from muscle breakdown that can lead to kidney failure and other complications. Prompt diagnosis and treatment are crucial. If you suspect you have rhabdomyolysis, seek immediate medical attention. The information provided here is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.