Rhabdomyolysis

Abstract

Rhabdomyolysis is a condition that results from the breakdown of skeletal muscle. The etiologies can be broken down into three main categories of causes: traumatic, atraumatic exertional, and atraumatic nonexertional. Patients with rhabdomyolysis often present with myalgia and are found to have myoglobinuria with elevations in serum creatine kinase levels. The mainstay in therapy is focused on restoration of intravascular volume with large-volume fluid resuscitation using isotonic fluids. Adequate hydration is necessary to prevent the potential complications of rhabdomyolysis, including the development of acute kidney injury. Practitioners should maintain a high level of suspicion of compartment syndrome in patients with rhabdomyolysis. If extremity compartment syndrome is diagnosed, prompt decompressive fasciotomies should be performed to preserve muscle and nerve viability. The early use of renal replacement therapy in patients with rhabdomyolysis has been described in the literature and may represent another modality of therapy to prevent the adverse sequelae of rhabdomyolysis. Key words: acute kidney injury, compartment syndrome, creatine kinase, disseminated intravascular coagulation, rhabdomyolysis