The treatment
The therapy of rhabdomyolysis can often not be causal. Thus, a muscle injury caused by trauma cannot be reversed. However, triggering drugs and toxins can be discontinued or flushed out of the body.
If a therapy of the cause is possible, it should be treated as soon as possible. Otherwise the therapy concentrates on the symptoms of rhabdomyolysis. The primary goal is to support the kidney in its function.
Since a great deal of waste products must be excreted via the kidneys, the administration of large quantities of fluid (over 5 liters) is recommended. In addition, medication (so-called diuretics) should be taken to force the kidneys to excrete a large amount of fluid. In order to control the excretion of fluids, fluid balancing is usually necessary.
For this purpose, all fluid intake and excretion quantities are added together. Even by weighing the kidneys daily, too much or too little fluid excretion can be quickly detected. In acute kidney failure, the kidney is usually not able to filter and excrete enough fluid, so that the excretion of muscle components is not guaranteed. For this reason, dialysis (blood washing by means of a machine) may be necessary in acute kidney failure.
The Complications
The most feared consequences of rhabdomyolysis are acute kidney damage and intravascular (inside the blood vessels) blood clotting, as these can quickly become life-threatening. A derailment of the electrolytes (blood salts) is also possible; this can lead to metabolic disorders as well as disturbances in muscle function and thus also in the heart muscles. A further complication is compartment syndrome, in which fluid retention leads to severe swelling of the muscles.
If the muscle does not have enough room to expand, it can perish. In rhabdomyolysis, kidney failure is due to excessive strain on the kidneys. As a result of the muscle decay, many substances that are toxic to the body are released from the cells and enter the bloodstream.
The kidney has to filter all these toxins from the blood and excrete them. Because of the high amount, the kidney can fail quickly. Especially the myoglobin, an important component of the muscles, can additionally clog the filter system of the kidney and thus additionally damage the kidney. Acute kidney failure can be life-threatening. You can find more information on this topic here: Acute renal failure.
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