Rhabdomyolysis (often called “rhabdo”) is a serious medical condition in which damaged skeletal muscle breaks down rapidly and releases its contents (deadly toxins) into the bloodstream.
When muscle fibers are injured or die, they leak intracellular proteins — most critically myoglobin — along with electrolytes, enzymes, and other cellular debris into the circulation. Myoglobin is toxic to the kidneys and can cause acute kidney injury or outright kidney failure.
Common Causes
- Crush injuries — trauma, accidents, prolonged immobilization
- Extreme exertion — intense exercise, military training (“exertional rhabdo”)
- Heat stroke
- Certain medications — especially statins at high doses
- Substance use — alcohol, cocaine, amphetamines
- Infections — viral myositis (e.g., influenza)
- Seizures — prolonged or repeated
- Electrolyte disorders — severe hypokalemia or hypophosphatemia
Key Symptoms
- Muscle pain, weakness, and swelling
- Dark, brown, or tea-colored urine (myoglobinuria — a hallmark sign)
- Decreased or absent urine output
- Fatigue, nausea, confusion
Complications
- Acute kidney injury (AKI) — the most dangerous complication
- Dangerous electrolyte imbalances (high potassium, low calcium)
- Compartment syndrome
- Cardiac arrhythmias
- Disseminated intravascular coagulation (DIC)
Diagnosis & Treatment Diagnosed by markedly elevated creatine kinase (CK) in the blood — often 5–10× or more above normal — along with urinalysis and metabolic panels.
Treatment centers on aggressive IV fluid resuscitation to flush myoglobin from the kidneys, correct electrolyte imbalances, and monitor kidney function. Severe cases may require dialysis.
Early recognition and hydration are key — outcomes are generally good when caught in time.