Post exertional hematuria

Abstract

The incidence of exercise-induced hematuria is reported to be between 5% and 25% and available literature suggests that it lasts for a few hours to a maximum of 3 days. We analyzed the urine sediment of healthy participants between the age of 20 and 50 years before and after a 5 km run. Anyone with abnormal pre-exercise sediment was excluded from the study. Of 491 participants, 59 (12%) developed post exercise hematuria when the run had to be completed in allotted time. However, when the run was completed without time limit, only 1.3% (4 of 316) developed hematuria (p50.001). We found that the younger participants (age530 years) had a significantly higher incidence of hematuria as compared to their older compatriots (p ¼ 0.019). The mean duration of hematuria was 1.98 ± 1.89 days and 81% of the participants cleared their hematuria within 3 days. In 12% it lasted between 3 and 7 days and in 7% it continued beyond 7 days. Three individuals had persistence of hematuria beyond day 14 and all these were found to have primary glomerular disease on renal biopsy [two had IgA nephropathy and one focal segmental glomerulosclerosis (FSGS)]. We conclude that exercise-induced hematuria can last up to a fortnight. However, if it persists beyond a fortnight, it is unlikely to be functional and an underlying cause is likely. Hematuria following exercise seems to be related to the intensity of effort during exercise rather than its duration.

Atypical anti-glomerular basement membrane disease presenting as macroscopic haematuria, loin pain and acute kidney injury after intensive exercise

“…Recurrent post-exercise haematuria is reported in healthy subjects probably because of an impaired GBM selectivity during exercise. Rarely the persistence of haematuria leads to a glomerulopathy diagnosis [1].…”

“…Post-exercise haematuria and post-exercise acute kidney injury (AKI) can reveal an underlying disease, for example, drepanocytosis, uropathy or renal hypo-uricaemia. Rarely Alport disease, immunoglobulin A (IgA) nephropathy or focal segmental glomerulosclerosis has been observed [1]. We report the case of a patient with an atypical anti-glomerular basement membrane (GBM) disease revealed by post-exercise AKI associated with macroscopic haematuria and loin pain.…”

Macroscopic hematuria caused by running‐induced traumatic bladder mucosal contusions

“…In our study, most patients were relatively young and ran long distances. In fact, there was a significantly higher hematuria incidence in the younger or longer distance runners than in older or shorter distance runnners . Furthermore, half of patients had gross hematuria relapse after restarting running.…”

“…In fact, there was a significantly higher hematuria incidence in the younger or longer distance runners than in older or shorter distance runnners. 8 Furthermore, half of patients had gross hematuria relapse after restarting running. Therefore, running without completely voiding the bladder and preventing dehydration by high fluid intake have been recommended to prevent running-induced hematuria.…”