Key result
Diuretic minimization and dietary counseling resolve resistant hypertension and mitigate AKI risk in an athlete.
Why the study?
Managing hypertension and kidney risk in competitive athletes is challenging due to rapid fluid and electrolyte shifts, dietary trends, and performance goals, with limited guideline direction.
Case Report (n=1)
Highlights the need for individualized, evidence-informed approaches to manage hypertension and kidney risk in competitive athletes, as standard guidelines may not fully apply.
Supports individualized HTN management in athletes with prior AKI; leaves open APOL1 testing for risk stratification.
BACKGROUND: Managing hypertension (HTN) and kidney risk in competitive athletes is challenging because of rapid fluid and electrolyte shifts, dietary trends, and performance goals. CASE SUMMARY: A 19-year-old football player presented with resistant HTN, recent hypovolemic acute kidney injury (AKI), and multiple cardiovascular risk factors. Diagnostics included secondary HTN work-up and genetic testing, revealing a single apolipoprotein L1 gene risk allele. Management included minimization of diuretic agents and tailored counseling on sodium and protein intake focused on chronic kidney disease risk, AKI prevention, cardiovascular protection, and performance. DISCUSSION: Current guidelines offer limited direction for athletes regarding timing and interpretation of kidney biomarkers and return to play or monitoring after AKI. The emerging role of sports nephrology in collaboration with sports medicine, sports cardiology, sports nutrition, athletic trainers, and exercise physiology can address evidence gaps and optimize individualized athlete management for cardiovascular-kidney metabolic syndrome. TAKE-HOME MESSAGES: Standard kidney and HTN guidelines may not fully apply to athletes; balancing health and performance requires nuanced, evidence-informed approaches.
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Safdar et al. (2026) conducted a case report in Resistant hypertension and acute kidney injury (n=1). Minimization of diuretic agents and tailored counseling on sodium and protein intake was evaluated. Tailored management including diuretic minimization and dietary counseling was utilized to address resistant hypertension and acute kidney injury risk in a 19-year-old competitive athlete.
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