What is the clinical evidence from this study?

Study design: Cohort. Population: Exertional rhabdomyolysis and acute kidney injury (n=19). Intervention: Intense operational training. Primary outcome: Exertional rhabdomyolysis and acute kidney injury.

What question did this study set out to answer?

This study aims to describe the incidence of exertional rhabdomyolysis and its link to acute kidney injury in military personnel during intense training.

June 27, 2026Journal of Nephrology

Acute kidney injury induced by exertional rhabdomyolysis in military personnel

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Key result

Intense operational training is linked to exertional rhabdomyolysis in ~100% of participants and frequent AKI.

n=19

Why the study?

Exertional rhabdomyolysis is relatively common among military personnel and can lead to acute kidney injury, prompting evaluation of accessible biochemical markers as early warning signs during intense operational training.

Population

19 recruits from the Brazilian Marine Corps completing the Amphibious Command Course

Design

Exploratory cohort study

Follow-up

Seven days

Authors

CLCíntia Verdan LucenaUniversidade Federal do Rio de Janeiro ZGZeinab GhasemishahrestaniSouth African Medical Research Council MXM XavierInstituto de Pesquisas da Marinha

Discussion

Member takes

Implication

Alerts to pre-renal AKI risk during intense military training; leaves open biomarker utility pending prospective studies.

Key Points

This study aims to describe the incidence of exertional rhabdomyolysis and its link to acute kidney injury in military personnel during intense training.
Included 19 recruits from the Brazilian Marine Corps undergoing a rigorous Amphibious Command Course.
Evaluated exertional rhabdomyolysis through serum creatine kinase, myoglobin, and lactate dehydrogenase.
Assessed kidney function using serum creatinine, urea, and phosphate; defined acute kidney injury per AKI Network criteria.
All participants developed exertional rhabdomyolysis, with nine exhibiting acute kidney injury classified as pre-renal.
Significant increases in serum CK, LDH, myoglobin, and AST were noted post-training.
CK levels declined post-mission, returning near baseline after seven days.

Study Design

Type

Cohort (n=19)

Structured PICO

Population

19 elite military recruits from the Brazilian Marine Corps who completed intense operational training, evaluated for muscle and kidney damage.

Exposure

Intense operational training (Amphibious Command Course) involving rigorous training and dietary restrictions in a tropical mountainous region

Outcome

Occurrence of exertional rhabdomyolysis and pre-renal or intrinsic acute kidney injurysurrogate

Intense military training in a tropical environment frequently induces exertional rhabdomyolysis and pre-renal acute kidney injury, highlighting the need for biomarker monitoring.

Limitations

Limited sample size (n = 19)
Findings should be considered preliminary
Requires validation in larger and more diverse cohorts before broad clinical application
limited sample size (n = 19)

Cite This Study

Lucena et al. (2026) conducted a cohort in Exertional rhabdomyolysis and acute kidney injury (n=19). Intense operational training was evaluated on Exertional rhabdomyolysis and acute kidney injury. Intense operational training induced exertional rhabdomyolysis in all 19 participants and pre-renal acute kidney injury in 9 participants.

synapsesocial.com/papers/6a3f6922aea7db3c19540108 https://doi.org/10.1093/joneph/aajaf030

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Acute kidney injury induced by exertional rhabdomyolysis in military personnel

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Acute kidney injury induced by exertional rhabdomyolysis in military personnel

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider