Summary
Definition
History and exam
Key diagnostic factors
- recent crush injury
- prolonged immobilization
- presence of other risk factors
- muscular pain or weakness
Other diagnostic factors
- general malaise
- dark urine
- muscular swelling
- muscular tenderness
- diminished peripheral pulse
- prolonged capillary refill
Risk factors
- trauma
- alcohol
- cocaine
- amphetamine
- phencyclidine
- narcotics
- diuretics
- statins
- salicylate toxicity
- toxins
- envenomation
- inflammatory disorders
- muscle hypoxia
- genetic disorders
- metabolic disorders
- infection
- increased body temperature
- antipsychotics
Diagnostic tests
1st tests to order
- serum creatine kinase (CK) level
- serum electrolytes
- renal function
- liver function
- CBC
- coagulation studies
- urine dipstick
- urine microscopy
- myoglobin levels
Tests to consider
- muscle biopsy
- thyroid-stimulating hormone
- erythrocyte sedimentation rate
- antinuclear antibodies
- toxicology screen
Treatment algorithm
crush injury and/or creatine kinase >5 times normal or >1000 IU/L
acute kidney injury refractory to initial therapy
Colaboradores
Autores
Chinmay Patel, MD, FASN
Nephrology Specialist
East Texas Kidney Specialists
Longview
TX
Divulgaciones
CP is an author of one reference cited in this topic.
Aditya Kadiyala, MD, MPH
Vice Chair
Department of Medicine
Division of Nephrology
University of Maryland
Charles Regional Medical Center
La Plata
MD
Divulgaciones
AK declares that he has no competing interests.
Agradecimientos
Dr Chinmay Patel and Dr Aditya Kadiyala would like to gratefully acknowledge Dr Mark Shapiro, Dr Courtney Sommer, and Dr Robert D. Mathis, previous contributors to this topic.
Divulgaciones
MS is an author of references cited in this topic. CS and RDM declare that they have no competing interests.
Revisores por pares
Timothy Albertson, MD, PhD, MPH
Chief
Division of Pulmonary and Critical Care Medicine
University of California, Davis
Sacramento
CA
Divulgaciones
TA declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Kodadek L, Carmichael Ii SP, Seshadri A, et al. Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document. Trauma Surg Acute Care Open. 2022;7(1):e000836.Texto completo Resumen
The Renal Association (UK). Clinical practice guideline: acute kidney injury (AKI). Aug 2019 [internet publication].Texto completo
Sawhney JS, Kasotakis G, Goldenberg A, et al. Management of rhabdomyolysis: a practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg. 2022 Jul;224(1 pt a):196-204.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Myocardial infarction
- Influenza
- Fibromyalgia
Más DiferencialesGuías de práctica clínica
- Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document
- Clinical practice guidelines for exertional rhabdomyolysis: a military medicine perspective
Más Guías de práctica clínica
Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad