Saturday, December 22, 2012

Rhabdomyolysis In Depth

Rhabdomyolysis is the breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the bloodstream.  Myoglobin is harmful to the kidneys and often causes kidney damage.  It's a protein that causes renal (kidney) damage and can lead to kidney failure if treatment is not seen about immediately.  When muscle is damaged, a protein called myoglobin is released into the bloodstream.  It is then filtered out of the body through the kidneys, as almost everything in the body is.  Myoglobin breaks down into substances, often enzymes, that can damage kidney cells.  It may be caused by any condition that damages skeletal muscle, especially injury.  Risk factors include: 

  • Alcoholism (with tremors)
  • Crush Injuries
  • Drugs, especially cocaine, amphetamines, statins, heroin, or PCP
  • Genetic Muscle Diseases
  • Heatstroke
  • Ischemia or necrosis of the muscles (which may occur with arterial occlusion, deep vein thrombosis (DVT), or other conditions)
  • Low Phosphate Levels
  • Seizures
  • Severe Exertion, such as marathon running or calisthenics 
  • Shaking Chills
  • Trauma
Symptoms Include: 

  • Abnormal Urine Color (dark, red, or cola-colored)
  • Decreased Urine Production
  • General Weakness
  • Muscle Stiffness or Aching (Myalgia)
  • Muscle Tenderness
  • Weakness of the Affected Muscles 
Other Symptoms Include: 

  • Fatigue
  • Joint Pain
  • Seizures
  • Weight Gain (Unintentional) 
Tests Used For Diagnosis:

  • Creatine Kinase (CK) Level
  • Serum Calcium
  • Serum Potassium
  • Urinalysis 
  • Urine Myoglobin Tests
This Disease May Also Affect The Results Of The Following Tests: 

  • CK Isoenzymes
  • Serum Creatinine
  • Urine Creatinine
Treatment: Getting fluids that contain bicarbonate may prevent kidney damage by quickly flushing myoglobin out of the kidneys.  Fluids may need to be given through a vein (an IV).  Some patients may need kidney dialysis.  Medicines that may be prescribed include diuretics and bicarbonate (if there is enough urine output).  Hyperkalemia, low blood pressure (hypotension), and low blood calcium levels (hypecalcemia), should be treated right away, if present.  Kidney failure should also be treated immediately.  The outcome depends on the amount of kidney damage.  If kidney failure is present, getting treated afterwards can reduce the risk of permanent kidney damage.  To help prevent this, drink plenty of fluids after strenuous exercise or after any condition or event that may have damaged skeletal muscle.  Stay Informed!

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