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Rhabdomyolysis

Rhabdomyolysis is the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood. These substances are harmful to the kidney and often cause kidney damage.

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Kidney anatomy

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Causes

When muscle is damaged, a protein called myoglobin is released into the bloodstream. It is then filtered out of the body by the kidneys. Myoglobin breaks down into substances that can damage kidney cells.

Rhabdomyolysis may be caused by injury or any other condition that damages skeletal muscle.

Problems that may lead to this disease include:

Symptoms

Symptoms may include:

Other symptoms that may occur with this disease:

Exams and Tests

A physical exam will show tender or damaged skeletal muscles.

The following tests may be done:

This disease may also affect the results of the following tests:

Treatment

You will need to get fluids containing bicarbonate to help prevent kidney damage. You may need to get fluids through a vein (IV). Some people may need kidney dialysis.

Your health care provider may prescribe medicines including diuretics and bicarbonate (if there is enough urine output).

Hyperkalemia and low blood calcium levels (hypocalcemia) should be treated right away. Kidney failure should also be treated.

Outlook (Prognosis)

The outcome depends on the amount of kidney damage. Acute kidney failure occurs in many people. Getting treated soon after rhabdomyolysis will reduce the risk of permanent kidney damage.

People with milder cases may return to their normal activities within a few weeks to a month. However, some people continue to have problems with fatigue and muscle pain.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Contact your provider if you have symptoms of rhabdomyolysis.

Prevention

Rhabdomyolysis can be avoided by:

Related Information

Acute tubular necrosis
Acute kidney failure
Necrosis
Shock
Arterial embolism
Deep vein thrombosis
Seizures
Toxicology screen
Heat intolerance
Heat emergencies
Alcohol use disorder

References

Long B, Koyfman A. Rhabdomyolysis. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 116.

O'Connor FG, Deuster PA. Rhabdomyolysis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 99.

Paine CH, Jefferson JA, Velez JCQ. Pathophysiology and etiology of acute kidney injury. In: Johnson RJ, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 70.

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Review Date: 8/28/2023  

Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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