A 34-year-old marathon runner collapses in hot weather with muscle pain and dark urine. CK is 42,000 U/L, creatinine is 186 micromol/L and potassium

Question

A 34-year-old marathon runner collapses in hot weather with muscle pain and dark urine. CK is 42,000 U/L, creatinine is 186 micromol/L and potassium is 5.4 mmol/L. He is alert after cooling and has no pulmonary oedema. What is the most appropriate next step in management?

Accepted Answer

Give intravenous crystalloid to maintain renal perfusion with frequent electrolyte monitoring

Answer

Start high-dose statin therapy for muscle injury

Answer

Discharge if temperature normalises

Answer

Give prophylactic dialysis before fluid therapy

Answer

Restrict fluid because urine is dark

Exertional rhabdomyolysis with acute kidney injury risk — SCE Acute Medicine MCQ

A 34-year-old marathon runner collapses in hot weather with muscle pain and dark urine. CK is 42,000 U/L, creatinine is 186 micromol/L and potassium is 5.4 mmol/L. He is alert after cooling and has no pulmonary oedema. What is the most appropriate next step in management?