Rhabdomyolysis

Question 1

What is rhabdomyolysis?

Answer 1

Condition where skeletal muscle tissue breaks down and releases breakdown products into the blood

Question 2

Name 2 products that may be released into the blood

Answer 2

• Myoglobin
• Potassium
• Phosphate
• Creatine kinase

Question 3

How can rhabdomyolysis lead to an AKI?

Answer 3

Breakdown products damage the kidney as they’re filtered, especially myoglobin which is toxic to the kidney in high concentrations

Question 4

Anything that causes significant damage to muscle cells can cause rhabdomyolysis - name 1 of these

Answer 4

• Prolonged immobility (frail patients that fall and spend time on the floor before being found)
• Extremely rigorous exercise beyond the person’s fitness level i.e. ultramarathon
• Crush injuries
• Seizures

Question 5

Name 2 signs and symptoms

Answer 5

• Muscle aches and pain
• Oedema
• Fatigue
• Confusion (particularly in elderly frail patients)
• Red-brown urine

Question 6

1) What is a key investigation in establishing the diagnosis?
2) Name 2 other investigations, and what they look for

Answer 6

1) Creatine kinase blood test
2) ECG (arrhythmias due to hyperkalemia), urine dipstick (myoglobinuria), U&Es (AKI, hyperkalaemia),

Question 7

1) What is the mainstay of treatment?
2) What else is important to do?

Answer 7

1) IV Fluids
2) Manage any complications