From the Guidelines
Drinking water can help mild rhabdomyolysis by flushing out muscle breakdown products and preventing kidney damage. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, in the absence of shock, confusion, or inability to swallow, first aid providers should assist or encourage individuals with exertional dehydration to orally rehydrate with any available rehydration drink or potable water.
Key points to consider when using water to help mild rhabdomyolysis include:
- Increasing fluid intake to produce clear or light yellow urine, which typically means consuming 2-3 liters of water daily
- Using oral rehydration solutions containing electrolytes, as electrolyte imbalances often occur with rhabdomyolysis, although the guidelines suggest that a 4% to 9% carbohydrate-electrolyte drink may be a reasonable choice over potable water if readily available 1
- Avoiding activities that caused the muscle breakdown initially and resting the affected muscles
- Hydrating to dilute the concentration of myoglobin and other muscle proteins in the blood, making them less likely to clog and damage the kidney's filtering system
It's essential to note that while drinking water can help mild rhabdomyolysis, moderate to severe cases require medical attention and often intravenous fluids, as oral hydration alone may be insufficient. If you experience dark urine, severe muscle pain, or weakness, seek medical care immediately even if you're increasing your water intake.
From the Research
Rhabdomyolysis and Hydration
- Rhabdomyolysis is a serious medical condition characterized by the breakdown of skeletal muscle tissue, leading to the release of toxic substances into the bloodstream, which can cause kidney damage and other complications 2, 3.
- Drinking water, or more specifically, aggressive fluid resuscitation, is a common treatment approach for rhabdomyolysis, aimed at restoring renal perfusion, increasing urine flow, and preventing acute kidney injury (AKI) 2, 4.
- Early and vigorous fluid resuscitation, typically involving large volumes of intravenous fluids, has been shown to be effective in reducing mortality and preventing AKI in patients with rhabdomyolysis 4.
Effectiveness of Fluid Resuscitation
- Studies have demonstrated that fluid resuscitation can help to stabilize circulation, mobilize edema fluids, correct hyperkalemia and acidosis, and protect against the nephrotoxic effects of myoglobinemia and hyperuricosuria 4.
- However, it is essential to note that the effectiveness of fluid resuscitation may depend on various factors, including the severity of rhabdomyolysis, the underlying cause, and the timing of treatment initiation 2, 4.
Mild Rhabdomyolysis and Drinking Water
- While the available evidence primarily focuses on severe rhabdomyolysis, it is reasonable to assume that drinking water, as part of a broader fluid resuscitation strategy, may also be beneficial for patients with mild rhabdomyolysis 5, 2.
- However, it is crucial to emphasize that mild rhabdomyolysis still requires medical attention, and treatment should be guided by a healthcare professional to ensure proper management and prevent potential complications 2, 3.