Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis

Rhabdomyolysis is a condition that happens when muscle is damaged. This releases pigments from the muscle and blood into the bloodstream. The kidney filters the pigments out of the blood. The pigments accumulate in the kidney, blocking up the filtering portion of the kidney. The kidney then fails. Conditions that cause rhabdomyolysis include crushing injuries to muscle, seizures, and exercise-related heat stroke. Other causes include severe frostbite, alcoholism, drug overdose, cocaine use, and as a side effect of some medicines. Occasionally, excessive high-endurance exercise by someone who is not trained adequately can also result in rhabdomyolysis. A history of one of the above causes followed by red or brown urine is diagnostic. Some blood work and a urinalysis will confirm the diagnosis. If rhabdomyolysis is diagnosed before the kidneys fail, it can usually be treated effectively in the hospital.

Living With Your Diagnosis
The main symptom of rhabdomyolysis is red or brown urine following one of the above causes. It may then proceed to decreased or absent urine production. This is a serious sign that should cause you to seek immediate medical care because this is a symptom of developing kidney failure.

Treatment takes place in the hospital. Initially, high volumes of intravenous fluids are administered to try to keep urine flow greater than 6 ounces an hour to flush the pigments through the kidney. Medicines are then given to make the urine alkaline and to increase urination, again with the goal of flushing the pigments out of the kidney. The main adverse effect of this treatment is fluid overload if the kidneys have already started to fail before starting treatment. If this is the case, dialysis (a kidney machine) may be necessary to remove fluid and wastes and to rest the kidney until it has time to recover. This may take weeks to months depending on the severity.

The DOs
If you have had one of the causes of rhabdomyolysis, particularly a crushing muscle injury or exercise-related heat stroke, you should seek medical care immediately if you notice red or brown urine. If you notice a recurrence of colored urine or a decrease in urine output after treatment for rhabdomyolysis, you should also seek immediate medical care. In any case, you need to stay well ydrated and drink plenty of fluids.

The DON’Ts
If you are at risk of rhabdomyolysis, you should not let yourself become dehydrated. This will increase the risk of pigments building up in the kidney. This is especially important if you have experienced exercise-induced heat stroke, because you are already dehydrated. Do not participate in high-endurance sporting events without adequate training.

When to Call Your Doctor
You should call your doctor for any onset or recurrence of red or brown urine. You should also seek immediate medical care if urination decreases or is absent.

Information on exercise-related rhabdomyolysis: http://www.gssiweb.com/library/sse/sse42S1.html