{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:32:45Z","timestamp":1794360765543,"version":"4.9.0"},"reference-count":41,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"unspecified","delay-in-days":61,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2026,2,19]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the clinical course and complications of exertional rhabdomyolysis, compare inpatient and outpatient management, and evaluate admission markers of acute kidney injury (AKI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective, multicentre study with consecutive inclusion of patients with rhabdomyolysis (creatine kinase (CK) \u22655000\u2009U\/L and\/or myoglobin \u22651000\u2009ng\/mL) with exercise as the precipitating factor, presenting to the emergency departments of four hospitals in Oslo and Akershus, Norway (2019\u20132022). Management followed usual care. Primary outcome was AKI, defined by Kidney Disease: Improving Global Outcomes criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 136 patients with exertional rhabdomyolysis (median age 28 years, 55% male), mainly after strength training (106, 78%); 62 (46%) were managed as inpatients and 74 (54%) as outpatients. Management was similar in both groups, consisting of fluids, serial blood tests, with a median follow-up of 3\u2009days. Complications were rare and no outpatients required escalation to inpatient care. Five (4%) patients developed AKI (median peak creatinine 217\u2009\u00b5mol\/L, 132\u2013410). Other major complications (severe electrolyte disturbances and compartment syndrome) occurred only in those with AKI.<\/jats:p>\n                    <jats:p>All patients who developed AKI had serum creatinine above the normal reference range at admission, though a few patients with elevated creatinine did not develop AKI (95% specificity). The myoglobin-to-CK ratio (\u22650.48) performed best among muscle injury biomarkers and might serve as a supportive high-risk marker (99% specificity).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No patient with a normal admission creatinine developed AKI in this cohort, supporting outpatient management as a safe option for otherwise healthy individuals when admission creatinine is within the reference range, provided follow-up is ensured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04118608\">NCT04118608<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjsem-2026-003214","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T14:21:51Z","timestamp":1772547711000},"page":"e003214","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Exertional rhabdomyolysis: clinical features, management, complications and prediction of acute kidney injury"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04118608","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04118608","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0173-8894","authenticated-orcid":false,"given":"Marie","family":"Vangstad","sequence":"first","affiliation":[{"name":"Department of Acute Medicine, Oslo University Hospital, Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, 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