Nguyen Tuan, 39, experienced an electric shock. Despite remaining conscious and showing no visible burns or necrosis, he later developed mild left chest tightness, muscle aches in his thighs, reduced urination, and dark urine.

Lab results at Tam Anh General Hospital Hanoi revealed creatine kinase (CK) levels at 3,465 U/L and CK-MB at 76,1 U/L. Master, Doctor Nguyen Quang Huy, from the Department of Nephrology and Dialysis, diagnosed acute rhabdomyolysis after the electric shock and ordered close hospital monitoring.

Rhabdomyolysis occurs when muscle cells are destroyed, releasing toxins like myoglobin, potassium, and uric acid into the bloodstream. Myoglobin is particularly dangerous for the kidneys. High levels of myoglobin deposit in the renal tubules, causing obstruction and direct toxicity to kidney tissue, which can lead to acute kidney failure. Additionally, potassium released from damaged muscle cells into the blood can trigger cardiac arrhythmias, ventricular fibrillation, or sudden cardiac arrest.

Doctor Huy examines Nguyen Tuan. *Photo: Tam Anh General Hospital*

Doctors note that many electric shock victims, lacking visible external burns, often become complacent. However, muscle damage can silently progress for hours after the accident.

Nguyen Tuan received aggressive intravenous fluid therapy combined with continuous oral rehydration to increase urine output and rapidly eliminate toxins. According to Doctor Huy, this is the primary measure in treating acute rhabdomyolysis. Early fluid administration helps maintain circulating volume, increases blood flow to the kidneys, and prevents myoglobin deposition in the renal tubules. Delayed treatment can result in acute kidney failure, necessitating emergency dialysis.

Concurrently, doctors closely monitored kidney function, urine output, electrolytes, and muscle enzymes to detect complications early. The patient also received pain medication and continuous cardiac monitoring to prevent arrhythmias.

After one day of intensive treatment, Nguyen Tuan's chest pain decreased, muscle aches improved, and urine gradually lightened. His CK levels dropped to 2,436 U/L. He was discharged with outpatient follow-up, advised to drink plenty of water. One month later, Nguyen Tuan's health was stable, with no muscle pain, no shortness of breath, normal heart and lung function, and clear urine.

Doctors emphasize that household electricity, despite being low voltage, can still cause severe damage to the heart, muscles, and kidneys. Electric shock victims should not monitor themselves at home if they experience severe muscle pain, reduced urination, dark urine, palpitations, chest tightness, or unusual fatigue. Early examination and treatment help prevent complications, reducing the risk of kidney failure, cardiac arrhythmias, and death.

Thanh Ba