Summer Intense Interval Training: Heat Exhaustion, Rhabdomyolysis, And Acute Kidney Injury

HISTORY: A 23-year-old Division 1 college football player, involved in intense summer strength and conditioning drills on the football field, was escorted to the sideline for evaluation due to experiencing symptoms of heat exhaustion. It is noteworthy that the athlete has been in the South of the U.S. for more than four weeks, having relocated from the Midwest of the U.S. Additionally, he has a history of hyperhidrosis. PHYSICAL EXAMINATION: The athlete's examination revealed excessive sweating, repetitive emesis, upper-body cramping, and lower-body cramping. Subsequently, immediate cooling and rehydration therapy were initiated at the Athletic Training clinic, incorporating cold whirlpool baths, fans to reduce core body temperature, and the administration of essential electrolytes. Following the initial evaluation, the athlete unexpectedly developed severe full-body cramps and reported significant discomfort, including dizziness, fatigue, and continued excessive sweating. Consequently, he was transferred to the Emergency Room at the Regional Medical Center for further assessment and treatment. DIFFERENTIAL DIAGNOSIS: 1. Heat stress nephropathy2. Hyperuricemia3. Prerenal Azotemia4. Dehydration-Induced Kidney InjuryTESTS AND RESULTS:Urine and Blood Samples:-Neutrophil Level was high: 6.5-White Blood Cells Level was high: 16.2-Creatinine Level was high: 1.6-Creatine Kinase was high: 829-Total Protein Level was high: 13.8-Albumin Level was high: 8.4-Glucose Level was high: 121-Estimated GFR Level was low: 72.4Rectal/Core Temperature-Temperature was at 103 FFINAL/WORKING DIAGNOSIS:Heat Exhaustion, Hypertension, Rhabdomyolysis, and Acute Kidney Injury (AKI) as a result of Hyperhidrosis and Depleted Potassium LevelsTREATMENT AND OUTCOMES:1. Indoor low-intensity aerobic activity, such as stationary bike riding and walking in the indoor facility. 2. At the beginning of the following week, he could begin light jogging outdoors and progress as tolerated to full activity. 3. Currently, the athlete has been able to follow through with a return to play protocol (RTP) that has allowed him to return to sport gradually, which allowed him to participate in fall camp. 4. Athletes' blood pressure, weight, and participation status have been monitored daily for safety.