title: Outcomes of exertional rhabdomyolysis following high-intensity resistance training.
abstract: BACKGROUND
  High-intensity resistance training (HIRT) programmes are increasingly popular amongst personal trainers and those attending gymnasiums. We report the experience of exertional rhabdomyolysis (ER) at two tertiary hospitals in Melbourne, Australia.
  
  
  OBJECTIVE
  To compare the clinical outcomes of ER with other causes of rhabdomyolysis.
  
  
  METHODS
  Retrospective cross-sectional study of patients presenting with a serum creatine kinase (CK) of greater than 25 000 units/L from 1 September 2013 to 31 August 2014 at two tertiary referral hospitals in Melbourne, Australia. Records were examined to identify care measures implemented during hospital stay, clinical outcomes during admission and on subsequent follow up.
  
  
  RESULTS
  Thirty four cases of rhabdomyolysis with a CK of greater than 25 000 units/L (normal range: 20-180 units/L) were identified during the 12-month study period. Twelve of the 34 cases (35%) had ER with 10 of 12 related to HIRT. No acute kidney injury, intensive care admission or death were seen among those with ER. All cases were managed conservatively, with 11 admitted and 9 receiving intravenous fluids only. In contrast, patients with rhabdomyolysis from other causes experienced significantly higher rates of intensive care admission (64%, P = 0.0002), acute kidney injury (82%, P = 0.0001) and death (27%, P = 0.069).
  
  
  CONCLUSIONS
  ER resulting from HIRT appears to have a benign course compared with rhabdomyolysis of other aetiologies in patients with a serum CK greater than 25 000 units/L. Conservative management of ER appears to be adequate, although this requires confirmation in future prospective studies.
authors.affiliation: Department of General Medicine, Austin Health, Melbourne, Victoria, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Huynh
authors.affiliation: Department of General Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Leong
authors.affiliation: Department of General Medicine, Austin Health, Melbourne, Victoria, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Jones
authors.affiliation: Department of Neurology, Austin Health, Melbourne, Victoria, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Crump
authors.affiliation: Department of General Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Russell
authors.affiliation: Shinbone Medical Centre, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Anderson
authors.affiliation: Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Steinfort
authors.affiliation: Department of General Medicine, Austin Health, Melbourne, Victoria, Australia.
authors.forename: D F
authors.initials: DF
authors.lastname: Johnson
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology; D000328:Adult; D001315:Australia; D003402:Creatine Kinase / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D055070:Resistance Training / Q000009:adverse effects*; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000453:epidemiology* / Q000209:etiology*; D062606:Tertiary Care Centers
chemical_list: D003402:Creatine Kinase
keywords: acute kidney injury; creatine kinase; eccentric contractions; exertional rhabdomyolysis; high-intensity resistance training