Rhabdomyolysis
Rhabdomyolysis Rhabdomyolysis is a disorder that involves rapid breakdown of skeletal muscle, due to an injury. As a result the components of the skeletal muscle cells are released into the blood stream. These may include phosphate, potassium and myoglobin. The protein myoglobin is found in the urine. However, destruction of skeletal muscle can increase the myoglobin levels in the urine which can damage the kidneys. The skeletal muscle is a type of muscle in our body, and is made up of muscle fibres. It helps to move the skeleton at joints. The muscles of arms and legs contain skeletal muscle cells. The kidneys perform the functions of filtering the blood. But as the blood is overloaded with the by-products (myoglobin, potassium) of skeletal muscle breakdown, the kidneys may find it extremely difficult to perform its daily task. This can result to kidney failure.
Causes of Rhabdomyolysis Rhabdomyolysis occurs with muscle injury. There are a number of factors responsible for causing injury to muscles. Metabolic syndrome such as ketoacidosis that are marked by excessive production of ketone bodies can also induce damage to the skeletal muscles. Other causes are given below: Exercise: Severe exercise or following a rigorous exercise program can disintegrate the skeletal muscle. Extreme muscle activity may injure the muscles. A prolong strenuous exercise such as running in marathons can be harmful to the skeletal muscles. Diseases: Medical conditions such as severe asthma, seizures, severe hyperthyroidism or too much diarrhoea or vomiting can lead to rhabdomyolysis.
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Causes of Rhabdomyolysis Trauma: Trauma such as a car accident, lightning strike or an electric shock can result into rhabdomyolysis. Alcoholism: Consuming alcohol increases the urinary rate and dehydrates the body, in turn making the muscles weak. Moreover, it hinders protein production, crucial for muscle growth. If this was not enough, drinking alcohol can also impair synthesis of testosterone, a hormone that assists in building muscles. Thus, binge drinking on a daily basis is likely to severely damage the skeletal muscles and may even destroy the muscle mass. No wonder, alcoholics face an increased risk of suffering from rhabdomyolysis. Seizures: As we all know, seizures are characterised by repetitive movement of skeletal muscles. In most cases, the duration of seizures vary from a few seconds to a minute or two.
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Causes of Rhabdomyolysis However, if seizure activity continues for prolonged periods of time (more than 5 minutes), it can induce breakdown of skeletal muscles, eventually leading to rhabdomyolysis. Heatstroke: Doing a physically taxing job for a considerable amount of time in the hot sun increases the body temperature above 104 degree Fahrenheit, a condition commonly referred to as heatstroke. Initially, a person affected with heatstroke experiences muscle cramps and headache but with no treatment and continued exposure to the sun the skeletal muscle fibre may rupture, causing rhabdomyolysis. Medicines: Statins given to high cholesterol patients, may damage the muscles. Statin medications often cause muscle aching. Overdose of diuretics (water pills) or aspirin is harmful, as it causes an electrolyte imbalance.
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Causes of Rhabdomyolysis Anti-cholesterol medicines, antidepressants or illegal drugs such as opiates, ecstasy and amphetamines may damage the muscles. Scientists believe that certain cholesterol lowering drugs such as crestor, clofibrate and gemfibrozil, may cause rhabdomyolysis. Crestor has also been linked to renal failure.
Symptoms • • • • • • • •
People having rhabdomyolysis often experience pain, swelling and weakness in their arms, legs or lower back. Other symptoms associated with this disease are as follows: Dark-coloured urine (abnormal urine colour) blood is found in the urine Muscle tenderness Bruising of muscles Joint pain Fast heartbeats Nausea Unintentional weight gain Seizures Fatigue Over time, rhabdomyolysis can harm the lungs, leading to breathing problems. Swollen hands and feet point towards fluid retention, which may be due to kidney failure.
Treatments Once the doctor diagnoses the condition, rapid treatment is a must to get a positive outcome. An easy way to prevent life-threatening complications from skeletal muscle disintegration is to practice generous hydration as early as possible. Patients are treated with intravenous hydration, where fluids are administered directly into the blood vessels via a catheter (tube). This reduces the harmful side effects of myoglobin. The increase in the amount of fluids due to intravenous hydration helps the kidneys to get rid of myoglobin. Blood Transfusion: In this procedure, the patient is given fresh blood via an intravenous line. Blood transfusion is done to replace the blood containing high amount of myoglobin and other substances with healthy blood.
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Treatments
Dialysis: This is a technique in which toxic substances are removed from the blood. This method is used only when the kidneys are not able to do their task of cleaning the blood. The dialysis machine is used to filter the blood. Dialysis may be required for a short period or for the rest of the life depending upon the severity of the condition. Surgery: Surgical procedure involves cutting the tissues that cover the muscles. This reduces the pressures on the nerves and blood vessels caused by the inflammation of the injured muscle. Proper hydration is essential after conditions that involve injury to the skeletal muscle. Also, after a strenuous exercise, one must not forget to consume plenty of fluids. This is necessary to dilute the urine, and eliminate the myoglobin protein out of the kidneys. With prompt treatment, severe complications can definitely be avoided, thereby increasing the chances of complete recovery.
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