Numerous factors have been involved in exercise-induced acute kidney injury (EIAKI), such as using non-steroidal anti-inflammatory drugs following exercise and idiopathic renal hypouricemia (IRHUC). IRHUC is an autosomal recessive inherited disorder characterized by impaired tubular uric acid transfer, impaired reabsorption, and accelerated uric acid secretion. Some IRHUC patients have been shown to have EIAKI. A 27-year-old police officer was admitted to the hospital due to anorexia and a serum creatinine level of 18 mg/dL, after a "tug-ofwar" game. After one dialysis sessions per day over five days, his creatinine dropped to 1.3 mg/dL. Six months later, he developed bilateral flank pain and red discoloration of urine, following a 300-meter chase of a convict, and his creatinine level increased to 2.3 mg/dL, which was corrected with proper hydration alone. Recurrent acute kidney injury can be due to hereditary renal hypouricemia, which should be considered among differential diagnoses for patients. DOI: 10.52547/ijkd.6992.