Acute Kidney Injury Secondary to Exertional Rhabdomyolysis: A Review of Published Cases
DOI:
https://doi.org/10.5281/zenodo.22279461Keywords:
Rhabdomyolysis, Acute kidney injury, Exercise, Creatine kinase, DialysisAbstract
Background: Exertional rhabdomyolysis is a recognized cause of acute kidney injury (AKI) in otherwise healthy individuals
undertaking unaccustomed or extreme physical exertion, yet reported renal risk varies enormously across settings.
Objective: To synthesize published case reports, case series, and cohort data on AKI complicating exertional rhabdomyolysis.
Methods: Narrative review of individual published cases, athletic and military case series, population-based cohorts, and
management guidelines. Findings: Population-based incidence is roughly 1-36 per 100,000 person-years depending on the cohort, while AKI complicating hospitalized or severe cases ranges from 1% (spin-class cohorts) to over 75% (pooled published case reports), reflecting strong publication bias. Peak creatine kinase (CK) correlates imperfectly with AKI; sickle cell trait and inadequate hydration are recurrent predisposing factors. Fluid resuscitation remains the mainstay of prevention; bicarbonate and mannitol lack proven
benefit. Conclusions: Renal outcomes after exertional rhabdomyolysis are generally favorable with early recognition and fluid therapy,
but severe cases can require dialysis; individualized risk assessment beyond CK alone is warranted.
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