Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. May 25, 2023; 12(3): 56-65
Published online May 25, 2023. doi: 10.5527/wjn.v12.i3.56
Acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise
Hiroshi Tamura
Hiroshi Tamura, Department of Pediatrics, Kumamoto University, Kumamoto 8608556, Japan
Author contributions: Tamura H wrote the paper and collected the data.
Conflict-of-interest statement: All the author declare that they have no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hiroshi Tamura, MD, PhD, Assistant Professor, Department of Pediatrics, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 8608556, Japan. bohm1905ht@kuh.kumamoto-u.ac.jp
Received: December 25, 2022
Peer-review started: December 25, 2022
First decision: February 8, 2023
Revised: February 22, 2023
Accepted: March 22, 2023
Article in press: March 22, 2023
Published online: May 25, 2023
Abstract
BACKGROUND

There are two known types of exercise-induced acute renal failure. One is the long-known myoglobinuria-induced acute renal failure due to severe rhabdomyolysis, and the other is the recently recognized non-myoglobinuria-induced acute renal failure with mild rhabdomyolysis. Exercise-induced acute renal failure was first reported in 1982. Non-myoglobinuria-induced acute renal failure is associated with severe low back pain and patchy renal vasoconstriction, and it is termed post-exercise acute renal failure because it usually occurs hours after exercise. It is also called acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE).

AIM

To makes a significant contribution to medical literature as it presents a study that investigated a not-widely-known type of exercise-induced acute renal failure known as ALPE.

METHODS

We performed a database search selecting papers published in the English or Japanese language. A database search was lastly accessed on September 1, 2022. The results of this study were compared with those reported in other case series.

RESULTS

The study evaluated renal hypouricemia as a key risk factor of ALPE. The development of ALPE is due to the sum of risk factors such as exercise, hypouricemia, nonsteroidal anti-inflammatory drugs, vasopressors, and dehydration.

CONCLUSION

In conclusion, hypouricemia plays a key role in the development of ALPE and is often associated with anaerobic exercise. The development of ALPE is a result of the cumulative effects of risk factors such as exercise, hypouricemia, NSAIDs, vasopressors, and dehydration.

Keywords: Acute kidney injury, Exercise, Vasoconstriction, Renal hypouricemia

Core Tip: Exercise is important for health maintenance and promotion. However, exercise-induced acute renal failure is a disease that athletes and doctors should be aware of. This paper makes a significant contribution to medical literature as it presents a study that investigated a not-widely-known type of exercise-induced acute renal failure known as Acute renal failure with severe Loin pain and Patchy renal ischemia after anaerobic Exercise (ALPE). Further, the study evaluated renal hypouricemia as a key risk factor of ALPE. The information in this paper can help clinicians make more accurate diagnosis, given that a significant proportion of patients with ALPE are undiagnosed. Further, this paper can increase awareness among athletes to help them prevent ALPE and reach their exercise goals.