Exercise-induced acute renal failure (ALPE) frequently develops in young healthy males after repeated anaerobic exercise such as a 200-m race. The recurrence rate is high.
The risk of ALPE is high in patients with renal hypouricemia, and in those who have a cold and take antipyretic analgesics before exercise.
Severe loin pain persists for 5 days (mean). Because of the pain, patients are often misdiagnosed as having ureteral stone.
Plain computed tomography (CT) after the administration of contrast medium (delayed CT) shows wedge-shaped contrast enhancement in the bilateral kidneys, which persists for 1–3 days.
Many patients have non-oliguric acute renal failure, with a good prognosis. However, some patients require dialysis. For treatment, hydration must be controlled, and nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided if possible. When oliguria is observed, dialysis therapy should be performed, as described for acute tubular necrosis.