A 31-year-old male of Pakistani origin presented with severe flank pain radiating to the abdomen which began after playing football. There was no history of trauma, and no other symptoms, however his serum creatinine was 294μmol/L(53-106).
Interestingly he described two similar episodes of acute kidney injury after exercise, age 19 and 28, both resolving after a week. They were investigated extensively with no cause found.
He had previously had fully treated tuberculosis, his only medication was Vitamin D supplementation.