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The incidence of acute kidney injury (AKI) associated with ultramarathon running is varied partially because onsite measurement of serum creatinine concentration (Cr) is rarely performed at races due to logistical challenges. We conducted a prospective observational study using blood samples from volunteer athletes before and immediately after the Leadville Trail 100 Run in August 2014. The goals of our study were to determine the incidence of those meeting the AKI criteria immediately following the ultramarathon race and to evaluate the utility of using medical equations to back‐calculate creatinine levels for runners without known baseline creatinine levels and to identify possible risk factors for developing AKI. We were able to collect pre‐race and post‐race blood samples on 64 and 84 volunteers, respectively. AKI was defined as a Cr increase (≥1.5 times or ≥0.3 mg/dl from baseline). Of the 37 runners for whom we had both pre‐ and post‐race blood samples, 18 (49%) met the criteria for AKI. Using two different methods of back‐calculating baseline estimated creatinine (a fixed eGFR [estimated glomerular filtration rate] and an aged‐based eGFR), 6 (16%) and 22 (59%) of 37 runners met the criteria for AKI, respectively. We found that there is no accurate way to estimate baseline Cr in this population.

[Purpose] Exercise-associated hyponatremia (EAH) is a well-known condition among endurance athletes at low altitudes. The incidence of EAH during ultramarathons at high altitudes warrants further investigation. This prospective observational study was conducted on the participants of the Leadville Trail 100 run, a 161- km race held at a high altitude (2,800 m-3,840 m).[Methods] Venous blood samples were collected before and immediately after the race. The participants completed an electronic survey after the race. Our main outcome measure was the post-race serum sodium ([Na+]) level.[Results] Of the 672 athletes who started the race, 351 (52%) successfully completed the event within the 30- hour cut-off. Post-race blood samples were collected from 84 runners (66 finishers). Both pre- and post-race blood samples were collected from 37 participants. Twenty percent of the post-race participants had EAH. Only one post-race participant had a [Na+] level of <130 mmol/L. All participants with EAH were asymptomatic. One participant had an abnormal pre-race [Na+] level (134 mmol/L). Female participants had a significantly higher rate of EAH than male participants (40% vs. 16%; p=0.039). Age, body mass index, weight changes, race completion status, nonsteroidal anti-inflammatory drug use, and urine specific gravity were not associated with the development of EAH. Lower postrace [Na+] levels were associated with higher serum creatine kinase values (R2=0.1, p<0.005).[Conclusion] High altitude (3,840 m peak) does not appear to enhance the incidence of EAH after an ultramarathon footrace. This suggests that ambient temperature (low temperatures reduce risk), sex (female predilection), endurance running, and overhydration are more prominent risk factors for EAH than high altitude.

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Background and Objectives: Infections is yet one of the life-threatening complications of the hematopoietic stem cell transplantation (HSCT). The myeloablative and immunosuppressive conditioning regimens, which are administered before HSCT, dampen the defense capacity of the recipients’ immune systems. In this condition, opportunistic infections, especially viral infections such as cytomegalovirus (CMV) can be reactivated and cause morbidity and mortality in HSCT patients. Here, we aimed to find out any possible relationship between types of conditioning regimen and CMV reactivation in allo- geneic HSCT patients. Materials and Methods: We retrospectively analyzed the data of 145 CMV-seropositive cases out of total 201 allo-HSCT patients, including age, gender, underlying disease, conditioning regimen, prophylaxis regimen and occurrence of acute graft-versus-host disease (aGVHD) to evaluate their roles in CMV reactivation. Results: Our result showed that conditioning regimen containing Busulfan and Fludarabine (P=0.003) or Cyclophospha- mide (P=0.02) significantly decrease the early CMV reactivation. Patients who developed aGVHD (P=0.003) and those who received anti-thymocyte globulin (ATG) as prophylaxis regimen (P=0.002), had 1.84 and 2.63 times higher risks of CMV reactivation, respectively. Conclusion: Our findings suggest the conditioning regimen, aGVHD and ATG as influencing factors for early CMV reacti- vation post-HSCT which should be considered in the future studies.