Rhabdomyolysis Treatment in Delhi, India

Symptoms of rhabdomyolysis are:

• Dark, red, or cola-coloured urine
• Decreased urine output
• General weakness
• Weakness of the affected muscles
• Joint pain
• Muscle stiffness or aching (myalgia)
• Muscle tenderness
• Seizures
• Fatigue
• Unintentional weight gain

Several factors can lead to rhabdomyolysis. This includes muscle injury and trauma. Some causes of rhabdomyolysis are explained as follows:

• High-intensity exercise: Performing high-intensity workouts without adequately giving the body time to heal may lead to rhabdomyolysis.
• Severe dehydration and overheating: Overheating causes the muscles to break down faster. At that rate, the kidneys cannot eliminate the released proteins without the intake of plenty of fluids.
• Trauma: Trauma to the muscles, such as crushing injury, severe burn, or lightning strike, can cause muscle fibres to disintegrate rapidly.
• Medications: Some medications tend to cause muscle breakdown. These include antidepressants, antipsychotic drugs, and antiviral drugs. Statin medications may also lead to rhabdomyolysis. This occurs mainly in people with diabetes or liver disease.
• Illegal drugs and alcohol: Certain medications, such as heroin, cocaine, LSD, and alcohol, are toxic. They may cause the muscles to deteriorate and develop rhabdomyolysis consequently.
• Long periods of inactivity: People who live a sedentary lifestyle and often experience loss of consciousness, falls, and difficulty getting up for an extended period may develop rhabdomyolysis.

To diagnose rhabdomyolysis, doctors do the following:

• Examine the patient and enquire about their medical history, personal history, use of drugs and alcohol, ongoing medications and allergies. 
• Urinalysis to assess the levels of myoglobin in the urine
• Blood tests to measure levels of creatinine kinase released by the disintegration of muscles.
• Muscle biopsy to determine the cause of rhabdomyolysis. This test is performed by:
  • Numbing the area to be tested.
  • Then, a small sample of the muscle is taken.
  • Finally, the sample is sent to the lab for testing.
• Genetic tests may be performed to assess the risk of developing rhabdomyolysis.

If rhabdomyolysis is diagnosed early, it can be treated successfully without any long-term damage to the kidneys. First, doctors often administer intravenous fluids to flush toxins released from the body due to muscle breakdown. In addition, people with severe rhabdomyolysis are put on dialysis or hemofiltration to address renal damage.

Further, people with traumatic and nontraumatic rhabdomyolysis are often given the same treatment. However, it may vary depending on the cause of the disease. People with severely high potassium levels require medicines that help lower it rapidly to prevent further complications.

Fluid recovery

When the condition is diagnosed, immediate administration of IV fluids is important. This helps eliminate the toxins and by-products of muscle breakdown. In addition, fluids should contain bicarbonate. This is because it helps eliminate myoglobin from the kidneys.

Medications

Doctors prescribe medicines like bicarbonate and diuretics to help the kidneys function. Moreover, treatment of hyperkalemia and hypocalcemia with IV fluids is also done.

Dialysis

People with renal damage and acute renal failure require dialysis. During this procedure, the blood from the body is taken out, cleansed of toxins in a dialyser, and sent back into the body.

Home Remedies for Rhabdomyolysis

In mild cases of rhabdomyolysis, some home remedies help with the recovery process. Home treatment aims at getting adequate rest to allow the muscles to recover. In addition, home treatment helps rehydrate the body to prevent further damage to the kidneys. In case of fatigue, recline in a comfortable position and relax. Consuming plenty of water and other liquids helps with hydration.

Problems that may predispose to rhabdomyolysis include:

• Trauma or crush injuries
• Extreme body temperature
• Ischemia or death of muscle tissue
• Alcohol abuse
• Seizures or muscle tremors
• Low phosphate levels
• Genetic muscle diseases such as McArdle's disease and Duchenne's muscular dystrophy
• Use of drugs like amphetamines, cocaine, statins, heroin, or PCP
• Severe exertion, such as marathon running or callisthenics
• Lengthy surgical procedures
• Severe dehydration

Complications may include:

• Acute tubular necrosis
• Harmful chemical imbalances in the blood
• Acute renal failure
• Shock due to low blood pressure

Reviewed by Dr. Kamal Palta, Head & Senior Consultant - Emergency Medicine, Emergency & Trauma on 29-Dec-2022.