CASE REPORT: RECURRENT ACUTE KIDNEY INJURY WITH SEVERE LOIN PAIN AND PATCHY RENAL ISCHAEMIA AFTER ANAEROBIC EXERCISE (ALPE) WITHOUT RENAL HYPOURICAEMIA IN A NEW ZEALAND EUROPEAN MALE

KELLY R1, SEMPLE D2,3, HARPER A4,5

1Auckland District Health Board, Auckland, New Zealand, 2Department of Renal Medicine, Auckland District Health Board, Auckland, New Zealand, 3School of Medicine, University of Auckland, Auckland, New Zealand, 4Adult Emergency Department, Auckland District Health Board, Auckland, New Zealand, 5Auckland Rescue Helicopter Trust, Auckland, , Auckland, New Zealand

Background: Acute kidney injury with severe loin pain and patchy renal ischaemia after anaerobic exercise (ALPE) is a rare clinical syndrome. ALPE has predominantly been described in Japanese and Korean populations to date. Many cases and most recurrent examples are associated with renal hypouricaemia.

Case Report: We describe a 28-year-old New Zealand European male without renal hypouricaemia who developed recurrent ALPE whilst performing elite-level sport. Avoiding elite-level anaerobic exercise was successful at preventing further episodes.

Conclusions: This report confirms the first known case of ALPE in a New Zealand European male and raises the possibility that ALPE is an under-recognised condition. Long-term outcomes of recurrent ALPE remain unclear, and preventative strategies should be implemented to preserve renal function. Avoiding intense anaerobic exercise is an effective preventative strategy.


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