Table 2

Rhabdomyolysis consensus summary

Problem	Recommendations/findings
Populations at risk	Large burden of injury involving muscle. Vascular injury or muscle ischemia. Extreme exertional demands/toxins.
Clinical findings	May be asymptomatic. Acute muscle weakness. Pain/tender/swelling involved extremity.
Laboratory findings	CK >5× upper limit of normal or >1000 IU/L. Elevated myoglobin, LDH, K+, Cr, and AST.
Fluid management	LR or NaCl (0.9 or 0.45%) initiated at 400 cc/hour.
Urine output goals	1–3 cc/kg/hour. Up to 300 cc/hour.
Diuretic/bicarbonate therapy	Diuretics not recommended. Bicarbonate not recommended.
Electrolyte abnormalities	Elevated K+ and phosphate. Decreased calcium.
Renal replacement therapy	No role for RRT in AKI prevention. Rhabdo with AKI: CRRT or intermittent RRT. No recommendation on RRT modalities.
Complications of rhabdomyolysis	AKI. DIC. Compartment syndrome.
Predictors of AKI development	Based on demographic and clinical laboratory variables. McMahon Score for RRT need.

AKI, acute kidney injury; AST, aspartate aminotransferase; CK, creatine kinase; Cr, creatinine; CRRT, continuous renal replacement therapy; DIC, disseminated intravascular coagulation; K+, potassium; LDH, lactate dehydrogenase; LR, lactated Ringer’s solution; RRT, renal replacement therapy.