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Rhabdomyolysis (rhabdo) is the breakdown of damaged skeletal muscle.

Muscle breakdown causes the release of myoglobin into the bloodstream. Myoglobin is the protein that stores oxygen in your muscles.

If you have too much myoglobin in your blood, it can cause kidney damage. It also releases huge amounts of potassium into the bloodstream, which can disrupt the electrical rhythm of the heart.

In the United States, medical professionals report about 25,000 cases of rhabdo each year.

Rhabdo is a severe condition that can lead to permanent disability or even death, but treatment through intravenous (IV) drip is available. A physician can also take steps to reduce kidney damage.

The initial symptoms of rhabdo can be subtle. They’re not specific and may look like other conditions. The symptoms of rhabdo include:

These symptoms may start to become apparent after muscle injury. Some people might not notice symptoms until a few days after an injury. You might not show any symptoms at all.

If you suspect that you have rhabdo, it’s a medical emergency. Seek treatment as early as possible to avoid the permanent or fatal effects of rhabdo.

Muscle injury always triggers rhabdo. However, in this case, “injury” doesn’t only refer to physical trauma — it can have physical, chemical, or genetic causes. Anything that severely damages the muscles can lead to rhabdo.

Trauma, heat, and exertion

Causes in this category include:

  • a crush injury, which can occur when something heavy falls on you
  • a heat stroke
  • a third degree burn
  • blocked blood vessels
  • a lightning strike
  • intense shivering
  • extreme muscle exertion
  • a car accident
  • intense exercise, such as marathon running

Genetic and metabolic disorders

Some people develop rhabdo due to genetic conditions, such as problems with the metabolism of:

  • lipids or fats
  • carbohydrates
  • purines, which are in certain foods, such as sardines, liver, asparagus

Metabolic problems, such as the following, can also trigger rhabdo:

Genetic disorders that can lead to rhabdo include:

Infection and inflammation

Many types of infection and inflammation can cause rhabdo, including:

Medications and toxins

One important cause of rhabdo is statin medications, which are cholesterol-lowering drugs that many people take. Statins include:

Although rhabdo only occurs in a few people who take statins, it’s important to be aware of the risk since many people take these medications. In 2011 and 2012, around 26 percent of people in the United States took statins.

The condition can also occur due to exposure to other drugs, certain toxins, and high levels of alcohol.

Other drugs that can cause rhabdo include:

There are many other potential causes. This is only a partial list.

Your doctor will look and feel the larger skeletal muscles in your body, especially any that ache, to check for tenderness. They may also perform urine and blood tests to confirm a rhabdo diagnosis.

Tests to determine muscle and kidney health may include testing levels of:

  • Creatine kinase. This is an enzyme found in the skeletal muscles, brain, and heart.
  • Myoglobin in blood and urine. This is a protein that’s a byproduct of muscle breakdown.
  • Potassium. This is another important mineral that may leak from injured bone and muscles.
  • Creatinine in blood and urine. This is a breakdown product created by injured muscle. Normally, the kidneys remove this from the body.

Elevated levels of these substances are signs of muscle damage.

If a team of medical professionals diagnoses rhabdo early in its progression, they can successfully treat it without long-term damage to the kidneys.

Most people with rhabdo receive fluids through their veins in an intravenous (IV) drip. Some people may require dialysis or hemofiltration to address kidney damage in more severe cases. People with traumatic and nontraumatic rhabdo often receive the same treatment, but this may vary depending on the specific cause.

People who have severely high potassium levels will receive medications that rapidly reduce levels in the bloodstream.

Fluid recovery

Getting enough fluid into your body is the first and most important treatment. A healthcare professional must start administering IV fluids quickly. This fluid should contain bicarbonate, which helps flush the myoglobin out of your kidneys.

Medications

Your doctor may prescribe medications such as bicarbonate and certain kinds of diuretics to help keep your kidneys functioning.

They can also treat high potassium levels in the blood (hyperkalemia) and low blood calcium levels (hypocalcemia) with appropriate IV fluids.

Dialysis

If kidney damage and acute renal failure have already started, you may need to receive dialysis. During dialysis, blood is taken out of the body and cleaned in a special machine to remove waste products.

Home remedies

In mild cases of rhabdo, home treatment can help aid in the recovery process. The goals of at-home treatment include resting the body so your muscles can recover and rehydrating to help prevent further kidney damage.

When you’re feeling fatigued, recline in a comfortable position and try to relax. Drink plenty of water and other clear liquids, such as light broth and sports drinks.

There are several ways to reduce your risk of rhabdo:

  • Hydrate before exercise. You can prevent rhabdo by drinking plenty of fluids before and after strenuous exercise. This will dilute your urine and help your kidneys eliminate any myoglobin that your muscles may have released during exercise.
  • Stay hydrated if you have an existing degenerative muscle condition or recent muscle trauma. You can prevent rhabdo by staying well-hydrated at all times.
  • Carry a full refillable water bottle with you at all times. Having a refillable water bottle means you’ll have access to something to drink at all times. Drink whenever you begin to feel thirsty. Don’t wait until your thirst increases.
  • See your doctor when you think you may be sick or have an infection. Addressing illness as soon as possible can help prevent muscle damage that may lead to rhabdo.

Your long-term outlook depends on the degree of kidney damage. If you catch rhabdo early and start receiving treatment immediately, you may be able to avoid major complications and return to normal health in a few weeks. Even then, however, you may still have some lingering weakness and pain in your muscles.

Acute kidney injury develops in 10 to 55 percent of people with rhabdo. If major kidney damage occurs, it may be permanent. But kidney injury is not always severe, and treatment is possible.

Several symptoms and complications of rhabdo are serious and may result in death or permanent disability if you don’t get treatment for them.