Co-occurrence of exercise-induced acute kidney injury and rhabdomyolysis in a holding cell at a police station: a case report

We present a rare case of a patient with co-occurring exercise-induced acute kidney injury (AKI) and rhabdomyolysis. A 67-year-old man was referred to our department with AKI. Five days before referral, the patient had sudden-onset loin pain while banging and kicking on a door in a holding cell at a police station. Diffusion-weighted magnetic resonance imaging showed wedge-shaped areas of signal hyperintensity in both kidneys. Serum and urinary myoglobin levels were mildly elevated. Kidney biopsy showed cellular injury of the tubular epithelial cells and myoglobin casts in the tubules. The patient was diagnosed with exercise-induced AKI and mild rhabdomyolysis and was treated conservatively. His kidney function improved gradually with no need for hemodialysis. This case report exhibits a unique presentation of the co-occurrence of exercise-induced AKI and rhabdomyolysis after intense anaerobic and aerobic exercise. To the best of our knowledge, this is the first report to pathologically demonstrate co-occurring exercise-induced AKI and rhabdomyolysis.