💪 Rhabdomyolysis Management
This tool frames rhabdomyolysis management by CK level, hyperkalemia, and renal function, directing aggressive fluids, monitoring, and dialysis indications.
Rhabdomyolysis Management
CK level
Hyperkalemia
Refractory hyperkalemia / severe AKI / volume overload
When to use
Use to anchor early aggressive fluid resuscitation, identify hyperkalemia as the most urgent threat, and decide when dialysis is needed.
How it works
CK > 1000 → aggressive 0.9% saline, urine output ≥ 200–300 mL/h until CK < 1000/myoglobinuria clears. Hyperkalemia → treat aggressively. Refractory hyperkalemia/severe AKI/volume overload → dialysis. Alkalinization/mannitol not routine.
Key points
- Mannitol and loop diuretics are never used before volume repletion because they can worsen renal perfusion. (original synthesis · not guideline verbatim)
- Hyperkalemia is the most pressing threat and drives continuous cardiac monitoring.
- Hypocalcemia is generally left uncorrected unless symptomatic or accompanying severe hyperkalemia.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.