Intense Training Leading to Dialysis: About an Original Cause of Acute Kidney Injury

Exercise-induced rhabdomyolysis (exRML) is a potentially life-threatening condition characterized by skeletal muscle breakdown following excessive physical exertion. The subsequent release of intracellular components, including myoglobin, creatine kinase, and electrolytes, into the bloodstream can cause severe complications such as acute kidney injury (AKI) and, in rare cases, death. The underlying mechanisms involve disturbances in calcium homeostasis, mitochondrial dysfunction, and structural damage to the muscle extracellular matrix. Although commonly reported in athletes and military personnel, exRML can also occur in otherwise healthy individuals with no prior medical history. What makes the present case noteworthy is that a previously healthy 24-year-old male developed severe AKI requiring hemodialysis after a single intense exercise session. This highlights that exRML can arise in non-athletic young adults and progress rapidly to life-threatening renal failure. The purpose of reporting this case is twofold: first, to raise awareness among clinicians that exRML should be considered even in low-risk populations; and second, to emphasize the importance of early recognition and prompt management to prevent irreversible renal damage and improve outcomes.