Rhabdo Rory — Rhabdomyolysis: Tea-Colored Urine, Potassium & Kidney Rescue
He pushed through the workout, then collapsed — and his urine came out the color of iced tea
Rory finished an extreme workout in the heat, then slept 12 hours. He wakes with thighs so sore he can barely stand, and the urine in the specimen cup is dark brown.
Rory's crushed and overworked muscle cells break open and dump their contents into the bloodstream: myoglobin, potassium, phosphate and creatine kinase. Myoglobin clogs the renal tubules and turns urine tea-colored or cola-colored, driving acute kidney injury. The potassium released from dying muscle is the fastest killer — it climbs quickly and can stop the heart. Treatment is aggressive IV fluid to flush the myoglobin through the kidneys, plus close monitoring of potassium, calcium and CK.
Read Rhabdo Rory's full story →The story arc
The setup
Rory does an all-out workout in hot weather after months off, then takes a statin as usual and goes to bed dehydrated.
The turn
The next morning his thigh muscles are swollen and exquisitely tender, and his urine is dark brown.
The crisis
Labs return with potassium 6.4 mEq/L, creatine kinase over 30,000 units/L, and rising creatinine. The monitor shows peaked T waves.
The save
The team starts high-volume IV normal saline, treats the hyperkalemia, monitors strict intake and output, and watches the CK trend down over several days.
NCLEX study section — Rhabdomyolysis: Tea-Colored Urine, Potassium & Kidney Rescue
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Health Assessment
Take this chapter into practice questions on the same topic.