Which electrolyte disturbance is particularly dangerous in rhabdomyolysis and can contribute to AKI?

• A. Hyponatremia
• B. Hyperkalemia
• C. Hypokalemia
• D. Hypercalcemia

Answer: (B)

Rhabdomyolysis causes the breakdown of skeletal muscle, releasing intracellular contents into the bloodstream. Potassium is highly concentrated inside muscle cells, so when a large amount of muscle lyses, a rapid surge in serum potassium follows, leading to hyperkalemia. This is dangerous because it quickly disrupts cardiac conduction, with progression from abnormal ECG changes to potentially life-threatening arrhythmias or cardiac arrest. In the setting of rhabdomyolysis, you’re also dealing with acute kidney injury from myoglobin toxicity to the renal tubules, so a severe electrolyte disturbance like hyperkalemia compounds the risk and demands urgent attention. Other electrolyte abnormalities can occur, but hyperkalemia is the most acutely dangerous in this context due to its immediate impact on heart function.