Episode 25: Rhabdomyolysis

Rhabdomyolysis management centers on fluid resuscitation to preserve renal function, though clinicians must avoid over-resuscitation when urine output remains low. While bicarbonate and diuretics like acetazolamide are sometimes employed to alkalinize urine or force diuresis, evidence supporting these interventions remains limited, making them secondary to careful volume management. Monitoring creatine kinase (CK) levels is essential for identifying the injury peak and detecting potential complications, such as compartment syndrome, rather than simply chasing arbitrary values. Dialysis serves as a last resort for standard indications like severe hyperkalemia or refractory volume overload, rather than a direct treatment for muscle breakdown. Ultimately, most cases follow a predictable clinical course, requiring clinicians to distinguish between mild, common presentations and severe, high-risk scenarios that demand aggressive, specialized intervention.