Rhabdomyolysis

Exam Cram

• Rhabdomyolysis is caused by muscle breakdown (usually from a long lie) releasing a large amount of creatinine with blocks up the kidney

• Presentation: fall + long lie, excess sympathmimoetic activation

• Investigations: raised CK +++, AKI, urine dip shows 'blood' but is myoglobin

• Management: IVF ++

Med Reg Notes

Causes 

Rhabdomyolysis is caused by any source of muscle breakdown: 

• Long lie (particularly in elderly or IVDU)

• Recreational drugs: stimulant excess

• Serotonin Syndrome, Neuroleptic Malignant Syndrome (NMS) 

Assessment

Investigations

• Acute renal failure (AKI) 

• Urine dip detects muscle (myoglobulinaemia) in urine but mistakes it for blood

• Hyperkalaemia, hyperphosphateamia and hypocalcaemia often seen

• Deranged LFTs commonly seen. 

Management

1. IVF

Can require large volumes of IVF, c.6L/d

This can result in polyuria, pseudo- post obstructive duiresis, reasonable to match IVF to be 50% of urine output with polyuria

Duiretics and urinary alkalisers do not affect outcomes. 

Resources and References

Written 2024