Non-myoglobinuric acute renal failure

Minimum rhabdomyolysis—non-myoglobinuric acute renal failure due to exercise-induced acute renal failure—ALPE (acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise) after sprint, short track event such as 200-m race, etc. 

The other type is non-myoglobinuric acute renal failure, in which intense exercise over a short period of time, such as sprinting, causes minimal rhabdomyolysis without myoglobinuria, i.e., acute renal failure syndrome with severe loin pain and patchy renal vasoconstriction [2]. A recent study showed that anaerobic exercise caused this syndrome, and proposed that Acute renal failure with severe Loin pain and Patchy renal ischemia after anaerobic Exercise (ALPE) (exercise-induced acute renal failure) was a new type of acute renal failure syndrome [4]. 

We compared ALPE (non-myoglobinuric acute renal failure) with myoglobinuric acute renal failure (Table 11). 

As shown in Fig. 76, exercise-related acute renal failure is classified into two types myoglobinuric acute renal failure and non-myoglobinuric acute renal failure. The latter is represented by ALPE. The grade of rhabdomyolysis and the type/grade of muscle fibers affected are shown in Fig. 76. Pathogenetic factors for ALPE should be investigated in the future. 

Fig. 76. Comparison of the pathogenesis between myoglobinuric acute renal failure and non myoglobinuric acute renal failure represented by ALPE (hypothesis)...

In 1982, we classified exercise-related acute renal failure into two types myoglobinuric acute renal failure, as had previously been reported, and non-myoglobin-related acute renal failure (exercise-induced acute renal failure). In 2002, the latter was named ALPE (Acute renal failure with severe Loin pain and Patchy renal ischemia after anaerobic Exercise) [4]. The term acute kidney injury (AKI) has recently been proposed as a patho-physiologically more correct alternative to the term acute renal failure. Therefore, exercise-induced acute renal failure in this book may be replaced by exercise-induced acute kidney injury. 

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