American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the target urine output rate for the treatment of rhabdomyolysis?

1. 100 mL/h

2. 200 mL/h

3. 300 mL/h

4. 400 mL/h

The correct answer is: 300 mL/h

In the management of rhabdomyolysis, the target urine output is prioritized to prevent acute kidney injury secondary to myoglobinuria. A urine output rate of 300 mL/h is considered effective in achieving this goal, as it helps to dilute nephrotoxic agents, thus minimizing their harmful effects on the kidneys. Maintaining a urine output of 300 mL/h ensures adequate hydration and assists in the excretion of myoglobin and other metabolites released from damaged muscle cells, which is crucial in avoiding renal complications. This volume allows for effective clearance and decreases the risk of tubular obstruction caused by myoglobin casts. Lower urine output targets might not provide sufficient flushing of the nephron and could lead to toxic accumulation, thereby potentially resulting in more significant renal impairment. The higher rate targeted is a safe measure in the context of treating rhabdomyolysis, making 300 mL/h the recommended goal in clinical practice.