Updates on Rhabdomyolysis: A Clinically Oriented Narrative Review

Abstract

Topic Importance: Rhabdomyolysis is the clinical syndrome resulting from the release of skeletal muscle cellular contents into the bloodstream, typically manifesting as limb weakness, myalgias, swelling, myoglobinuria, electrolyte abnormalities, and, critically, acute kidney injury (AKI). Recognition of this complex of clinical and biochemical features is necessary for accurate diagnosis and subsequent management. Review Findings: A precise consensus definition of rhabdomyolysis remains elusive. The McMahon score has proven useful for identifying patients at the highest risk for serious complications and outcomes. Treatment involves careful electrolyte monitoring, crystalloid resuscitation, and dialysis; hyperosmolar therapy remains controversial. Future research should involve randomized controlled trials delineating the role of hyperosmolar therapies, urine alkalinization, and treatment bundles in patients hospitalized with this clinical syndrome. The goal of this clinically oriented review was to provide an updated summary of the existing evidence and essential knowledge required for the care for patients admitted to the hospital with rhabdomyolysis, including an examination of the syndrome's epidemiology, pathophysiology, clinical manifestations/approach essentials, and basics of management.