28-year-old man, soldier.
When he restarted his physical training with the intention of participating in a triathlon, after having been 2 months without intense physical activity, he walked 45 kilometers on a bicycle and then turned up to an intense heat.
Dizziness, abdominal pain, nausea, vomiting, diarrhoea, constipation
muscle weakness and severe muscle cramps in the limbs
He was hydrated in the emergency service and sent home afterwards.
The patient was admitted to the hospital due to muscle weakness, diffuse myalgia, cramps and general malaise.
He had scarcely urinated since the day before.
There was a decrease in strength in the extremities and pain to muscle palpation.
The admission tests showed azotemia and elevated muscle enzymes.
Urine was pink and sediment showed 1-2 erythrocytes per field.
Acute renal failure secondary to stress MRI was diagnosed and treated in the intensive care unit.
There he received isotonic saline solution, bicarbonate and furosemide, quickly recovering diuresis.
In the following 9 days, a paulatine recovery of renal function was achieved without dialysis, persisting myalgia, cramps and elevation of muscle enzymes.
She was discharged on the 11th day of hospitalization with mild azotemia (creatinine 1.43 mg/dl, uremia 51 mg/dl) and persistence of elevated creatine kinase (CK)-total.
One month later, when the patient was physically active, renal function and muscle enzyme levels were normal.
