Exertional rhabdomyolysis with acute kidney injury resulting from lower extremity training: a case report

Abstract

Introduction: Acute kidney injury (AKI) is a severe complication of rhabdomyolysis, a clinical syndrome characterized by the damage of skeletal muscle and the subsequent release of its breakdown products into the bloodstream. Case Presentation: A 32-year-old previously healthy male who had generalized body pain, dark-colored urine, nausea, and vomiting for 2 days, presented to the hospital after he performed a vigorous gym workout. Blood results revealed creatine kinase of 39 483 U/l (normal range: 1–171 U/l), myoglobin 224.9 ng/ml (normal range: 0–80 ng/ml), serum creatinine 4.34 mg/dl (normal range: 0.6–1.35 mg/dl), and serum urea 62 mg/dl (normal range: 10–45 mg/dl). Based on clinical and laboratory findings, he was diagnosed with exercise-induced rhabdomyolysis with AKI; he was successfully treated with isotonic fluid therapy and titrated accordingly without requiring renal replacement therapy. After 2 weeks of follow-up, a full recovery was seen. Clinical Discussion: Between 10 and 30% of people with exercise-induced rhabdomyolysis are thought to develop AKI. Exercise-induced rhabdomyolysis is typically characterized by symptoms such as muscle discomfort, weakness, fatigue, and black urine. An initial diagnosis is often made when creatine kinase levels are more than five times the upper limit, and there has been a recent history of intense physical activity. Conclusion: This case highlighted the potentially life-threatening risks associated with unexpected physical activity and underlined the critical preventative steps to lower the likelihood of experiencing exercise-induced rhabdomyolysis.