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Dr Pinaki Mukhopadhyaye, Kolkata 02 December 2019

Exercise-induced acute kidney injury (AKI) usually reflects massive rhabdomyolysis and Myoglobinuric acute renal failure due to marathon, mountain climbing, etc.
Nonmyoglobinuric acute renal failure due to exercise-induced acute renal failure is ALPE (acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise) after sprint, short track event such as 200 m race, etc.
ALPE frequently develops in young healthy males after repeated anaerobic exercise.
The number of ALPE case was highest in September, when many athletics meetings and sports festivals are held.
In typical ALPE - Serum levels of creatine phosphokinase and myoglobin, which are normal or slightly increased. Severe loin pain several hours after exercise and Wedge-shaped contrast enhancement on plain CT is characteristic.
It is speculated that loin pain is vascular spasm-related pain, i.e., the involvement of renal angina.
Risk factors of ALPE renal hypouricemia, exercise in present of cold, administration of antipyretic analgesics before exercise and exercise in the presence of dehydration.
Outcome is favorable in early diagnosis and treatment.

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