Elevated CK levels post workout with kidney condition

I am a 28 year old female who has been advised by her nephrologist to decrease the intensity of her workouts after blood CK levels the day following a workout (squats and deadlift) was 1278 U/L.

I have been working out since 2017, starting with mostly bodybuilding style exercises and then into SBD.

I had Henoch-Schonlein purpura vasculitis December 2019 and stopped working out for about 12 months. The small blood vessels in my kidneys were damaged as a result of the vasculitis. I now have proteinuria and have been prescribed Atacand (blood pressure lowering medications) to manage the kidney damage. My CK levels have never been abnormal in the past, although I don’t recall if I worked out the day prior to those previous blood tests.

I just started to get back into a routine following my vasculitis and the pandemic and it’s a bit discouraging to hear that my workouts are now “too intense”. The nephrologist says those CK levels suggest I’m working out “too hard” and may even be bad for my kidneys in the long run.

Any thoughts on what my nephrologist has suggested? He’s been great, but didn’t know what a deadlift was when I told him what I did for my workouts haha.

It remains unclear why these CK levels are being checked, unless you are having signs of muscle inflammation (myositis) or symptoms concerning for rhabdomyolysis in association with your workouts.

My thoughts are that I would not agree that a CK level of 1200 is concerning, nor do they necessarily reflect workouts that are “too intense”. I am not aware of any evidence that these transient low levels cause kidney damage (compared with true rhabdomyolysis, which is what they may be thinking about here).

This thought process also fails to consider the risk/benefit trade-off of your current workout regimen; for example, if you were limited to extremely low-load/low-intensity exercise, perhaps your CK levels never rise … but perhaps you never provide enough stimulus to build up your bone density during these younger years of your life, increasing your risk of osteoporosis and its complications (or other health issues) down the road.

Thanks for your response Dr. Baraki!

For more context, I complete bi-annual 24-hour urine tests as well as blood work to monitor my kidney function and CK level has never been a focus in my discussions with my nephrologist over the past 2 years. We’ve kept close eyes on my creatinine and protein levels.

I also did a repeat blood test 7 days after the 1200U/L CK levels were detected and did not workout at all during that time as requested by my nephrologist. My CK levels dropped to about 200 U/L for that repeat blood work.

Anyways, I think I’ll keep my current exercise routine and see how things go at my bi-annual check in haha.​