Key Points
- To describe the clinical presentation, diagnosis, and non-dialytic management of severe exercise-induced rhabdomyolysis complicated by acute kidney injury.
- Clinical and laboratory assessment of a 32-year-old previously healthy male presenting with severe muscle pain, vomiting, and dark urine after intense gym exercise (N=1).
- Diagnostic evaluation via serum creatine kinase, myoglobin, creatinine, and urea levels.
- Administration of titrated intravenous isotonic fluid therapy without renal replacement therapy, followed by a 2-week outpatient follow-up.
- Initial laboratory testing revealed extreme elevations of creatine kinase (39,483 U/l; normal: 1-171 U/l), myoglobin (224.9 ng/ml; normal: 0-80 ng/ml), serum creatinine (4.34 mg/dl; normal: 0.6-1.35 mg/dl), and serum urea (62 mg/dl; normal: 10-45 mg/dl).
- Isotonic fluid resuscitation reversed renal impairment without the need for renal replacement therapy, achieving complete clinical recovery at 2 weeks.
Structured PICO
PPopulationA 32-year-old previously healthy male presenting with exercise-induced rhabdomyolysis and acute kidney injury after a vigorous gym workout
IInterventionIsotonic fluid therapy
Prompt treatment with isotonic fluid therapy can successfully manage severe exercise-induced rhabdomyolysis with acute kidney injury without the need for renal replacement therapy.