Snapshot A 26-year-old woman has just finished running a full marathon. She did not stop as often as she would have liked for water to rehydrate during her 26.2 mile run. She reports feeling lightheaded and has mild muscle soreness. When she went to use the restroom, she noticed that her urine was dark – almost like tea. At an urgent care clinic, her serum creatine kinase is found to be elevated. An ECG is shown here. Introduction Clinical definition login to view 3 more bullets Epidemiology Risk factors login to view 3 more bullets Etiology Common associations login to view 6 more bullets Pathogenesis login to view 14 more bullets Presentation Symptoms login to view 9 more bullets Physical exam login to view 3 more bullets Studies Labs login to view 10 more bullets Urine dipstick login to view 1 more bullet Urinalysis login to view 4 more bullets Electrocardiogram (ECG) login to view 2 more bullets Diagnostic criteria login to view 1 more bullet Differential Hemolysis causing hemoglobinuria (dark urine) login to view 1 more bullet Treatment Conservative login to view 3 more bullets Medical login to view 7 more bullets Complications Acute kidney injury Cardiac arrest from hyperkalemia Prognosis generally good with early detection, supportive care, and careful monitoring