Exercise-induced rhabdomyolysis

Ann Emerg Med. 1994 Jun;23(6):1301-6. doi: 10.1016/s0196-0644(94)70356-6.


Study objective: To describe the syndrome of exercise-induced rhabdomyolysis and to investigate the relation between exercise-induced rhabdomyolysis and the development of acute renal failure.

Design: Retrospective chart analysis on all patients with a discharge diagnosis of rhabdomyolysis from January 1988 to January 1993.

Setting: An urban tertiary care center with 225,000 annual emergency department visits.

Type of participants: Thirty-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).

Results: All 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.

Conclusion: Previous 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.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / urine
  • Adult
  • Creatine Kinase / blood
  • Emergency Service, Hospital
  • Exercise*
  • Humans
  • Incidence
  • Male
  • Retrospective Studies
  • Rhabdomyolysis / blood
  • Rhabdomyolysis / complications*
  • Rhabdomyolysis / epidemiology
  • Rhabdomyolysis / urine
  • Risk Factors


  • Creatine Kinase