Understanding Rhabdomyolysis: Causes, Signs and Symptoms

Acute kidney injury have developed in 33% of patients suffering from this skeletal muscle syndrome (Torres et. al, 2015). Skeletal muscle tissues release toxins that can cause buildup within the kidneys. The large amount of toxins that were accumulated within the kidneys are serum creatine kinase, creatinine, potassium, and calcium as well as myoglobin (Chatzizisis et. al, 2008). The accumulation of myoglobin is nephrotoxic to the kidneys. Hypovolemia is another factor that leads to renal hypo perfusion (Chatzizisis et. al, 2008). Baywater and Beall first discovered how Rhabdomyolysis induce acute renal failure in 1941 after following the progress of 4 victims had developed acute renal failure in London in 1940. Some decades later, they found out that nephrotoxic effect from myoglobin was released by muscle cells and was responsible for ruptured muscle cells (Chatzizisis et. al, 2008). About 10-40% were estimated in the cases of Rhabdomyolysis lead to acute renal failure (Chatzizisis et. al,

Crush syndrome is a life-threating medical emergency in which rhabdomyolysis develops after prolonged compression of the limbs.7 It is most frequently characterized by hemodynamic shock, hyperkalemia, metabolic acidosis, and myoglobinuric acute renal failure. 7 Direct traumatic pressure initiates cell death through mechanical disruption of myocytes, followed by ischemic injury.7 After the release of pressure, ischemia reperfusion injury combined with an increase in vascular permeability cause edema of the skeletal muscles.4 A rapid rise in intracompartmental pressures (ICP) ensues leading to Acute Compartment Syndrome.10 Prolonged elevation of ICP greater than 35-40 mmHg can lead to cellular ischemia and widespread muscle necrosis.11

Rhabdomyolysis results when the skeletal muscle rapidly breaks down and releases myoglobin into the bloodstream. Myoglobin is a protein that composes muscle cells that carry and store oxygen in the muscles. Therefore, when myoglobin is released into the bloodstream, the skeletal muscle rapidly deteriorates and is rapidly being destroyed. Rhabdomyolysis can lead to renal kidney failure. Renal kidney failure is when the kidneys can’t remove waste and urine. In some cases, rhabdomyolysis can lead to death. However, there is treatment for rhabdomyolysis.

muscles run out of oxygenated blood and the arteries cannot keep up with the demand because of

Rhabdomyolysis is the breakdown of muscle fibers due to injury. The injury may come from physical damage to the muscle like an injury but other causes are:

Rhabdomyolysis means destruction or disintegration of striated muscle. This syndrome is characterized by muscle breakdown and necrosis resulting in the leakage of the intracellular muscle constituents into the circulation and extracellular fluid [1]. One of the key compounds released is myoglobin, an 18,800-Dalton oxygen carrier.

Rhabdo means striated, myo refers to muscle, and lysis is the breakdown of (Criddle, 2003). Rhabdomyolysis is a pathological condition that occurs due to a direct or indirect muscle injury (Giannoglou, Chatzizisis, & Misirli, 2007). Following injury and cell damage, the leakage and release of toxic intracellular material into the blood leads to serious complications like electrolyte abnormalities, acidosis, clotting disorders, hypovolemia, and kidney failure (Criddle, 2003). After direct plasma membrane rupture, there is an increase in intracellular calcium and sodium, which the body responds by activating several proteases, leading to mitochondrial dysfunction, intensifying muscle cramps and pain, and may result in gradual muscle cell death

Rhabdomyolysis or myoglobinuria, is the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood. These substances are harmful to the kidney and often cause kidney damage. When muscle is damaged, a protein called myoglobin is released into the bloodstream. It is then filtered out of the body by the kidneys. Myoglobin breaks down into substances that can damage kidney cells( Medline, 2015). Serum Creatine Kinase (CK) is most useful in the measurement in the condition. CK levels greater than 1000 units/L are indicative of the condition, levels that exceed 5000 unit/L indicate acute renal failure. Rhabdomyolyis, is most frequently seen in traumas that involve crush injuries, immobilization for long periods, and drug and alcohol overdoses. Although the condition is rare, serious complications including hyperkalemia, metabolic acidosis, acute renal failure and DIC (McCance..).

The title Reflex Sympathetic Disease was originally used to describe pain disorders, under the belief that sympathetic hyper activity was somehow involved in abnormal activity at the periphery.5 However, there still remained a large number of patients who were difficult to categorize into one or the other pain syndromes (RSD/ causalgia/Sympathetically Maintained pain (SMP)).5 Therefore the term complex regional pain syndrome (CPRS) came about.5 CPRS type I corresponds with the former term RSD, CPRS type II corresponds with the former term causalgia, and CPRS type III corresponds with patients who might not fulfill the criteria for CRPS I or II which puts them in this third category of “not otherwise

Some people complain of a loss of balance, this is probably because the muscles become unable to compensate for an off-balance posture. Serious injury from tripping and falling down is a common risk with Inclusion Body Myositis. In addition severe muscle pain is another commonly noted symptom. The diagnosis for IBM, although difficult, simply because the symptoms may be caused by other illnesses, is based on clinical signs and subsequent testing. Many tests can help diagnose the disease , including a blood test that screens for creatine kinase or CK levels. The result of muscle cell damage is the blood enzyme CK. High CK levels would then show strange muscle damage. An electromyography, which is a technique for recording the electrical activity of muscles, can be used to recognize characteristic abnormalities. The best way to diagnose Inclusion Body Myositis , however, is a muscle biopsy, where a small sample of muscle is removed for laboratory analysis (IBM illnessopedia,n.d.,para 3) . Muscle resonance imaging scans may also reveal changes in the muscles. (Travers, P. ,2010, June 17)

Rhabdomyolysis is rare. The muscle tissue breaks down and releases myoglobin in the blood. This can damage the kidneys. Some symptoms include dark urine, muscle aches, and weakness. Fewer than two hundred thousand cases

While the cause of Raynaud’s is unknown, factors such as: exposure to cold, underlying disease processes, chemical exposure, cigarette smoking, injury/trauma, repetitive hand actions, and medications can increase the risk of developing the condition (University of Rochester Medical Center, 2016, para. 4). Although Raynaud’s has been diagnosed in more than one family member, a hereditary factor has not been

Acute renal failure occurs when your kidneys suddenly become unable to filter waste products from your blood. As a result, dangerous levels of wastes may accumulate and your blood’s chemical makeup may get out of balance. It is usually caused by an event that leads to kidney malfunction such as dehydration, blood loss from a major surgery or injury, or the use of certain medications. Symptoms of decreased kidney function, such as fluid buildup or electrolyte imbalance are more likely to develop with acute renal failure, regardless of how long the kidney itself has been malfunctioning. The signs and symptoms present may reflect the actual cause of the kidney problem. For instance, an obstruction in the urinary tract may cause flank pain, blood

Prerenal failure is associated with ischemic damage caused by hypoperfusion of the kidney resulting from a myriad of possible causes. Intrarenal failure results from damage caused by intrinsic renal pathologies of the glomeruli, tubules, or parenchyma such as acute tubular necrosis, acute glomerulonephritis, acute pyelonephritis, or nephrosclerosis. Postrenal failure results from injury caused by the obstruction of urinary outflow. This patient experienced prerenal failure as a result of kidney hypoperfusion. Hypovolemia is the most common cause of prerenal failure. This can be due to hemorrhage, diarrhea, vomiting, burns, overuse of diuretics, and third-spacing (similar etiologies as dehydration and hypovolemia). This patient’s acute prerenal failure resulted from hypovolemia and hypotension that originated from a severely dehydrated state which was caused by excessive diaphoresis and inadequate fluid

Rhabdomyolysis is defined as: “a clinical and biochemical syndrome that occurs when skeletal muscle cells disrupt and release creatinine phosphokinase (CK), lactate dehydrogenase (LDH), and myoglobin in the interstitial space and plasma.” (Althay, Bezerra, Loborio & Daher, 2008. p. 721). The breakdown of muscle will set forth the release of the guts, per say, of the cell which will also pertains to myoglobin. It is this myoglobin that will occlude the tubules, this occlusion will lead to injury of the kidney’s nephron. (Huether & McCane, 2017. p. 997). It is stipulated by Althayd et al. that when the patient is not hypovolemic that myoglobin is less caustic to the