Rhabdomyolysis (patient information): Difference between revisions
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'''For the WikiDoc page | __NOTOC__ | ||
'''For the WikiDoc page on this topic, click [[Rhabdomyolysis|here]].''' | |||
{{CMG}}; {{AE}} [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org] | |||
{{Rhabdomyolysis (patient information)}} | {{Rhabdomyolysis (patient information)}} | ||
==Overview== | ==Overview== | ||
Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream. Some of these are harmful to the kidney and frequently result in kidney damage. | Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents ([[myoglobin]]) into the bloodstream. Some of these are harmful to the [[kidney]] and frequently result in kidney damage. | ||
==What are the symptoms of Rhabdomyolysis?== | ==What are the symptoms of Rhabdomyolysis?== | ||
*Abnormal urine color (dark, red, or cola colored) | *Abnormal urine color (dark, red, or cola colored) | ||
*General weakness | *General [[weakness]] | ||
*Muscle stiffness or aching (myalgia) | *Muscle stiffness or aching ([[myalgia]]) | ||
*Muscle tenderness | *Muscle tenderness | ||
*Weakness of the affected muscles | *Weakness of the affected muscles | ||
Additional symptoms that may be associated with this disease include the following: | Additional symptoms that may be associated with this disease include the following: | ||
*Fatigue | *[[Fatigue]] | ||
*Joint pain | *[[Joint pain]] | ||
*Seizures | *[[Seizures]] | ||
*Weight gain (unintentional) | *[[Weight gain]] (unintentional) | ||
==What causes Rhabdomyolysis?== | ==What causes Rhabdomyolysis?== | ||
When muscle is damaged, a protein pigment called myoglobin is released into the bloodstream and filtered out of the body by the kidneys. Myoglobin breaks down into potentially harmful compounds. It may block the structures of the kidney, causing damage such as | When muscle is damaged, a protein pigment called myoglobin is released into the bloodstream and filtered out of the body by the kidneys. Myoglobin breaks down into potentially harmful compounds. It may block the structures of the [[kidney]], causing damage such as rhabdomyolysis or [[kidney failure]]. | ||
Dead muscle tissue may cause a large amount of fluid to move from the blood into the muscle, reducing the fluid volume of the body and leading to shock and reduced blood flow to the kidneys. | Dead muscle tissue may cause a large amount of fluid to move from the blood into the muscle, reducing the fluid volume of the body and leading to shock and reduced blood flow to the kidneys. | ||
The disorder may be caused by any condition that results in damage to skeletal muscle, especially trauma. | The disorder may be caused by any condition that results in damage to [[skeletal muscle]], especially trauma. | ||
==Who is at highest risk?== | ==Who is at highest risk?== | ||
*Alcoholism (with subsequent muscle tremors) | *[[Alcoholism]] (with subsequent muscle tremors) | ||
*Certain inherited or genetic syndromes | *Certain inherited or genetic syndromes | ||
*Crush Injuries | *Crush Injuries | ||
*Heat intolerance | *Heat intolerance | ||
*Heatstroke | *[[Heatstroke]] | ||
*Ischemia or necrosis of the muscles (as may occur with arterial occlusion, deep venous thrombosis, or other conditions) | *[[Ischemia]] or [[necrosis]] of the muscles (as may occur with arterial occlusion, [[deep venous thrombosis]], or other conditions) | ||
*Low phosphate levels | *Low phosphate levels | ||
*Seizures | *[[Seizures]] | ||
*Severe exertion such as marathon running or calisthenics | *Severe exertion such as marathon running or calisthenics | ||
*Shaking chills | *Shaking chills | ||
*Trauma | *[[Trauma]] | ||
*Use or overdose of drugs, especially cocaine, | *Use or overdose of drugs, especially [[cocaine]], [[amphetamine]]s, [[statin]]s, [[heroin]], or PCP | ||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
| Line 50: | Line 51: | ||
*CPK is very high. | *CPK is very high. | ||
*Serum myoglobin test is positive. | *Serum myoglobin test is positive. | ||
*Serum potassium may be very high | *Serum [[potassium]] may be very high | ||
*Urinalysis may reveal casts and be positive for hemoglobin without evidence of red blood cells on microscopic examination. | *Urinalysis may reveal casts and be positive for hemoglobin without evidence of red blood cells on microscopic examination. | ||
*Urine myoglobin test is positive. | *Urine myoglobin test is positive. | ||
| Line 60: | Line 61: | ||
==Treatment options== | ==Treatment options== | ||
Early and aggressive fluids (hydration) may prevent kidney damage by rapidly flushing myoglobin out of the kidneys. Fluids may need to be given through a vein (by IV). Some patients may need kidney dialysis. | Early and aggressive fluids (hydration) may prevent kidney damage by rapidly flushing myoglobin out of the kidneys. Fluids may need to be given through a vein (by IV). Some patients may need kidney [[dialysis]]. | ||
Medicines that may be prescribed include diuretics and bicarbonate (if urine output is sufficient). | Medicines that may be prescribed include [[diuretics]] and [[bicarbonate]] (if urine output is sufficient). | ||
Hyperkalemia and low blood calcium levels (hypocalcemia) should be treated if present. Kidney failure should be treated as appropriate. | [[Hyperkalemia]] and low blood calcium levels ([[hypocalcemia]]) should be treated if present. [[Kidney failure]] should be treated as appropriate. | ||
==Where to find medical care for Rhabdomyolysis?== | ==Where to find medical care for Rhabdomyolysis?== | ||
| Line 79: | Line 80: | ||
==Prevention== | ==Prevention== | ||
Drink plenty of fluids after | Drink plenty of fluids after strenuous exercise to dilute the urine and flush the myoglobin out of the kidney. Proper hydration is also necessary after any condition or event that may involve damage to [[skeletal muscle]]. | ||
[[Category:Kidney diseases]] | [[Category:Kidney diseases]] | ||
[[Category:Organ failure]] | [[Category:Organ failure]] | ||
[[Category:Nephrology]] | [[Category:Nephrology]] | ||
[[Category:Intensive care medicine]] | [[Category:Intensive care medicine]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Patient information]] | [[Category:Patient information]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 15:35, 22 April 2013
For the WikiDoc page on this topic, click here.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ujjwal Rastogi, MBBS [2]
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Rhabdomyolysis |
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Rhabdomyolysis On the Web |
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Overview
Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream. Some of these are harmful to the kidney and frequently result in kidney damage.
What are the symptoms of Rhabdomyolysis?
- Abnormal urine color (dark, red, or cola colored)
- General weakness
- Muscle stiffness or aching (myalgia)
- Muscle tenderness
- Weakness of the affected muscles
Additional symptoms that may be associated with this disease include the following:
- Fatigue
- Joint pain
- Seizures
- Weight gain (unintentional)
What causes Rhabdomyolysis?
When muscle is damaged, a protein pigment called myoglobin is released into the bloodstream and filtered out of the body by the kidneys. Myoglobin breaks down into potentially harmful compounds. It may block the structures of the kidney, causing damage such as rhabdomyolysis or kidney failure.
Dead muscle tissue may cause a large amount of fluid to move from the blood into the muscle, reducing the fluid volume of the body and leading to shock and reduced blood flow to the kidneys.
The disorder may be caused by any condition that results in damage to skeletal muscle, especially trauma.
Who is at highest risk?
- Alcoholism (with subsequent muscle tremors)
- Certain inherited or genetic syndromes
- Crush Injuries
- Heat intolerance
- Heatstroke
- Ischemia or necrosis of the muscles (as may occur with arterial occlusion, deep venous thrombosis, or other conditions)
- Low phosphate levels
- Seizures
- Severe exertion such as marathon running or calisthenics
- Shaking chills
- Trauma
- Use or overdose of drugs, especially cocaine, amphetamines, statins, heroin, or PCP
When to seek urgent medical care?
Call your health care provider if symptoms indicate rhabdomyolysis may be present.
Diagnosis
An examination reveals tender or damaged skeletal muscles.
- CPK is very high.
- Serum myoglobin test is positive.
- Serum potassium may be very high
- Urinalysis may reveal casts and be positive for hemoglobin without evidence of red blood cells on microscopic examination.
- Urine myoglobin test is positive.
This disease may also alter the results of the following tests:
- CPK isoenzymes
- Urine creatinine
- Serum creatinine
Treatment options
Early and aggressive fluids (hydration) may prevent kidney damage by rapidly flushing myoglobin out of the kidneys. Fluids may need to be given through a vein (by IV). Some patients may need kidney dialysis.
Medicines that may be prescribed include diuretics and bicarbonate (if urine output is sufficient).
Hyperkalemia and low blood calcium levels (hypocalcemia) should be treated if present. Kidney failure should be treated as appropriate.
Where to find medical care for Rhabdomyolysis?
Directions to Hospitals Treating Rhabdomyolysis
What to expect (Outlook/Prognosis)?
The outcome varies depending on the extent of kidney damage. Acute kidney failure occurs in many patients. Treatment soon after rhabdomyolysis begins will reduce the risk of chronic kidney damage.
People with milder cases may return to normal activity within a few weeks to a month or more. However, some continue to have problems with fatigue and muscle pain.
Possible complications
- Rhabdomyolysis
- Acute renal failure
Prevention
Drink plenty of fluids after strenuous exercise to dilute the urine and flush the myoglobin out of the kidney. Proper hydration is also necessary after any condition or event that may involve damage to skeletal muscle.