What is the initial treatment for rhabdomyolysis?

• A. Blood transfusion
• B. Generous amounts of intravenous fluids
• C. Immediate dialysis
• D. Restriction of fluids

Answer: (B)

The goal in rhabdomyolysis treatment is to protect the kidneys by promoting urine output and flushing myoglobin and other toxins from the renal tubules. The best initial step is aggressive intravenous fluid resuscitation, typically with isotonic saline, to maintain renal perfusion and increase urine flow so the kidneys can clear the toxic breakdown products. This approach directly targets the main risk in rhabdomyolysis: acute kidney injury from myoglobin and electrolyte disturbances. Blood transfusion isn’t the appropriate first move because the issue isn’t blood loss or anemia. Immediate dialysis is reserved for established kidney failure or severe, refractory electrolyte disturbances rather than as the first step. Restricting fluids would reduce kidney perfusion and worsen the risk of injury, so it’s not suitable as initial management. Monitoring urine output and electrolytes guides subsequent adjustments, but starting with generous IV fluids addresses the core problem right away.