• R Sinert, L Kohl, T Rainone, and T Scalea.
• Department of Emergency Medicine, State University of New York Health Science Center, Brooklyn/Kings County Hospital Center.
• Ann Emerg Med. 1994 Jun 1;23(6):1301-6.

Study ObjectiveTo describe the syndrome of exercise-induced rhabdomyolysis and to investigate the relation between exercise-induced rhabdomyolysis and the development of acute renal failure.DesignRetrospective chart analysis on all patients with a discharge diagnosis of rhabdomyolysis from January 1988 to January 1993.SettingAn urban tertiary care center with 225,000 annual emergency department visits.Type Of ParticipantsThirty-five patients met the inclusion criteria for exercise-induced rhabdomyolysis: a history of strenuous exercise, creatine phosphokinase level more than 500, and urine dipstick positive for blood without hematuria. We excluded patients with a history of trauma, myocardial infarction, stroke, or documented sepsis. Charts also were examined for the presence of nephrotoxic cofactors (ie, hypovolemia and/or acidosis).ResultsAll 35 patients were men without significant past medical history and were an average age of 24.4 years. The average admission creatine phosphokinase was 40,471 U/L. No patient presented with or developed nephrotoxic cofactors during hospitalization. None of our study patients experienced acute renal failure.ConclusionPrevious literature has described a 17% to 40% incidence of acute renal failure in rhabdomyolysis. None of our patients developed acute renal failure, signifying a much lower incidence of acute renal failure in exercise-induced rhabdomyolysis without nephrotoxic cofactors than in other forms of rhabdomyolysis.

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