Exertional rhabdomyolysis and acute kidney injury in endurance sports: a systematic review The increasing dissemination of endurance events in sports such as swimming in open water, cycling, running and triathlon has led to concerns about possible impact on renal function and kidney health. This study aimed to examine the results for rhabdomyolysis under load and acute renal failure in endurance sports, whereby the diagnostic criteria used as well as the physical and ecological context conditions, among which rhabdomyolysis reported under load and acute renal failure, were highlighted. According to the PRISMA guidelines for systematic reviews and meta-analyzes, topic-related studies were searched in digital sources (from 2009 to 2020). Studies with biomarkers of rhabdomyolysis under load and acute renal failure reported on endurance or ultra-endurance events have been included. A total of 43 publications were extracted, and 345 (43.5%) persons were with rhabdomyolysis under burden (creatinine kinase> 5'000 UI / l) and 130 (16.39%) with rhabdomyolysis under load and acute renal failure (creatinine ≥ 1, 88 mg / dl) diagnosed). Of the total cases of rhabdomyolysis under stress and acute renal failure, 96.92% were ultra-runner. There were inconsistencies between studies on diagnostic criteria for rhabdomyolysis under load and acute renal failure, which showed a difficulty in the interpretation of the data. Increased muscle and kidney damage immediately after endurance events have been reported, but after 5.86 days, these values normally returned to the initial value. There is a lack of knowledge about the potential of repeated rhabdomyolysis under stress and acute renal failure predisposing long-term chronic kidney disease.
For the analysis of kidney health after endurance events, more accurate markers are needed for the subclinical and functional diagnosis of acute renal failure.Rhabdomyolysis under load and acute kidney failure are serious clinical problems with significant morbidity.Further research could help to define future prevention strategies. The whole analysis can be found under https://pubmed.ncbi.nlm.nih.gov/32202487/