Rhabdomyolysis

Rhabdomyolysis is a condition in which damaged muscle tissue breaks down and releases substances from the cells into the bloodstream, which can lead to kidney failure. If the patient has only mild symptoms, they should rest and drink plenty of fluids. However, severe cases may require hospitalization.

Symptoms of rhabdomyolysis

Rhabdomyolysis can cause different symptoms in different patients, which may or may not involve muscle symptoms. The main symptoms are as follows:

• Muscle weakness, especially large muscles in the arms and legs, and difficulty moving.
• Muscle pain in the shoulder, lower back, or thighs
• Urine is reddish brown or cola-colored.

Other symptoms that may occur are as follows:

• Thirsty, little urination
• Feeling unwell, weak, feverish
• Weight gain without cause
• There are bruises all over the body.
• Joint pain
• Stomach ache, nausea, vomiting
• Heart beats fast
• Confused, restless
• Convulsions, unconsciousness

Causes of rhabdomyolysis

Rhabdomyolysis occurs when damaged striated muscles break down and release myoglobin into the bloodstream. If too much of this substance occurs, it can damage the kidneys.

Factors that may cause this condition include:

• Genetic muscle disorders
• Metabolic disorders such as abnormal carbohydrate and fat metabolism, imbalance of electrolytes in the body, acidosis from diabetes or hypothyroidism.
• Severe dehydration
• Abnormally high or low body temperature, which may be caused by a high fever, heatstroke, burns, or scalds.
• Muscle ischemia or death, severe muscle tremors, muscle inflammation, convulsions
• Strenuous exercise or continuous exercise for a long period of time, such as running a marathon.
• Accidents such as car crashes, electric shocks, or lightning strikes, etc.
• Bacterial or viral infections such as influenza, herpes, and HIV, etc.
• Exposure to toxic substances, such as snake bites.
• Use of certain medications such as statins such as atorvastatin, rosvastatin, and pravastatin, etc., or other medications such as inhaled anesthetics, cephalosporins, colchicine, or erythromycin, etc.
• Drinking large amounts of alcohol
• Use of drugs such as methamphetamine, cocaine, heroin, ecstasy, etc.

Diagnosis of rhabdomyolysis

The doctor will perform a physical examination of the patient, checking for tenderness in large striated muscles, especially in the area of ​​pain. The doctor may also need to test for substances in the blood and urine, such as:

• Potassium , which increases in quantity when muscles are damaged.
• Calcium Muscle injury causes a decrease in the amount of calcium in the blood.
• Creatinine is a substance produced by the breakdown of muscle tissue and is eliminated from the body through the kidneys.
• Creatine kinase is an enzyme found in skeletal muscle, brain, and heart, and is detected in high levels when muscle is broken down.
• Myoglobin is also a protein produced by the breakdown of muscle tissue.

Treatment of rhabdomyolysis

Patients with mild symptoms can manage their symptoms and treat themselves at home with various methods, such as reducing exertion, getting plenty of rest to allow muscles to recover, drinking plenty of fluids or eating a liquid diet to prevent kidney damage, etc.

Patients with severe symptoms should be hospitalized , possibly in the ICU or intensive care unit, to receive close care and treatment for their symptoms, as follows:

• Fluid replacement is the most important treatment. Doctors may give the patient intravenous salineor bicarbonate-containing fluids to replace body fluids and help remove myoglobin from the kidneys, which helps maintain the function of the heart and other organs in the body.
• Medication: Your doctor may prescribe bicarbonate or certain diuretics to help your kidneys function properly, along with treating electrolyte imbalances, such as high blood potassium or low blood calcium.
• Dialysis is used to replace the function of the kidneys to help remove waste from the body in cases where kidney tissue is damaged or acute kidney failure occurs.
• Surgery is used to treat tension or pressure that causes lack of blood flow to the muscle, in cases where the patient has nerve damage or muscle death from abnormally high muscle pressure.
• Other treatments: Doctors may consider other treatments if the rhabdomyolysis patient is taking medications or has other underlying diseases, such as diabetes or various types of thyroid conditions. The patient must consult a doctor to stop taking the medication or adjust the medication as appropriate.

Most patients can recover normally. Patients should consult their doctor about foods or activities that should be avoided after treatment and strictly follow the doctor’s advice to prevent the disease from recurring.

Complications of rhabdomyolysis

Common complications of rhabdomyolysis include:

• Abnormally high pressure in the muscle, which can cause poor blood circulation and may damage the tissue in that area.
• An imbalance of substances in the blood can be dangerous, such as high blood potassium,which can cause an irregular heartbeat or cardiac arrest.
• Liver dysfunction
• Permanent kidney damage if kidney tissue is severely damaged or if acute kidney failure occurs
• Hypotension shock
• Death if not treated properly

Prevention of rhabdomyolysis

Rhabdomyolysis can generally be prevented by:

• Drink water as soon as you feel thirsty. Always carry water with you to avoid dehydration.
• Drink plenty of water before, during and after exercise to dilute your urine and help your kidneys remove myoglobin from your body.
• Drink more water if you are exercising and have muscle damage or injury. People with muscular dystrophy may drink more water than the general population after strenuous activity.
• See a doctor if you have symptoms or suspect that you may have rhabdomyolysis.