Association between collapse and serum creatinine and electrolyte concentrations in marathon runners: a 9-year retrospective study

Fitzpatrick, Daniel; Walter, Edward; Leckie, Todd; Richardson, Alan; Stacey, Michael; Hunter, Alex; Short, Steven M.; Hill, Neil; Woods, David R.; Grimaldi, Rachael; Galloway, Rob; Hodgson, Luke

doi:10.1097/mej.0000000000000739

Cited by 4 publications

(3 citation statements)

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“…While we demonstrated a mean increase of 2.0°C in core body temperature during the EHST, elevations in KIM-1 have typically occurred following more prolonged exercise 52 and can help explain why we did not observe significant changes in KIM-1 despite moderate hyperthermia, which is suggested to cause elevations in AKI biomarkers 6 . The combination of physical exertion, thermal strain, and heat illness has been associated with rises in serum creatinine 53 , although it is unclear if these changes reflect kidney injury. As such, we included KIM-1 as a more specific AKI marker, and clearly the minimal response was not associated with any significant kidney injury.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Biomarkers of Physiological Stress at Rest and Post-exertional Heat Stress

et al. 2022

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The purpose of this study was to assess the reliability of blood biomarkers that can signify exercise-induced heat stress in hot conditions. Fourteen males completed two heat stress tests separated by 5-7 days. Venous blood was drawn pre- and post- heat stress for the concentration of normetanephrine, metanephrine, serum osmolality, copeptin, kidney-injury molecule 1 and neutrophil gelatinase-associated lipocalin. No biomarker, except copeptin, displayed systematic trial order bias (p ≥ 0.05). Normetanephrine, copeptin and neutrophil gelatinase-associated lipocalin presented acceptable reliability (CV range: 0.9-14.3%), while greater variability was present in metanephrine, osmolality and kidney-injury molecule 1 (CV range: 28.6-43.2%). Normetanephrine exhibited the largest increase (p <0.001) in response to heat stress (trial 1 = 1048 ± 461 pmol. L-1; trial 2 = 1067 ± 408 pmol. L-1), whilst kidney-injury molecule 1 presented trivial changes (trial 1 = -4 ± 20 ng. L-1; trial 2 = 2 ± 16 ng. L-1, p >0.05). Normetanephrine, copeptin and neutrophil gelatinase-associated lipocalin demonstrated good reliability and sensitivity to an acute bout of heat stress. These biomarkers may be suitable for application in laboratory and field research to understand the efficacy of interventions that can attenuate the risk of thermal injury whilst exercising in the heat.

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Section: Discussionmentioning

confidence: 99%

Reliability of Biomarkers of Physiological Stress at Rest and Post-exertional Heat Stress

et al. 2022

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“…La investigación y literatura actual ha centrado el foco en el enfermo cardiaco grave en este tipo de situaciones 2 , sin embargo, no es despreciable la gran variedad de atenciones que se realizan en estos eventos implicando al resto de aparatos y sistemas del organismo. Deshidrataciones, presíncopes y alteraciones endocrino-metabólicas, entre otras, son muy frecuentes en estos pacientes y normalmente implican la presencia de alteraciones en los parámetros de la analítica sanguínea 3,4 .…”

Section: Introductionunclassified

Changes in blood test findings in participants in public running events

González Ruiz,

Ortiz Fernández,

Holguin Labajo

et al. 2024

Rev Esp Urg Emerg

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INTRODUCCIÓN. Las carreras populares generan un aumento significativo de la demanda asistencial para los servicios de emergencias con patologías en las que la realización de una analítica sanguínea tiene gran repercusión, ya que son frecuentes los trastornos del equilibrio ácido-base, electrolíticos y del resto de parámetros de la misma. MATERIAL Y MÉTODOS. Estudio descriptivo y retrospectivo, revisando informes asistenciales de un servicio de emergencias presente en la carrera popular de una gran ciudad de los pacientes a los que se realizó una analítica sanguínea prehospitalaria de 2013 a 2021. RESULTADOS. Se incluyeron 148 pacientes, con una edad media de 40 años, principalmente varones (83,1%). El pH se encontraba alterado en el 51% de los pacientes, siendo frecuentes los trastornos mixtos. La hiperlactacidemia se encontró en el 95,9% de los casos, con una concentración plasmática media de 5,07 mmol/l (DE: 2,79). Al menos existía una alteración iónica en el 75% de los casos. Creatinina, glucemia, hematocrito y bicarbonato también fueron parámetros afectados. CONCLUSIÓN. El analizador sanguíneo es una herramienta útil en la valoración de la patología aguda del corredor de maratón debido a la presencia de numerosos trastornos hidroelectrolíticos y del equilibrio ácido-base.

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“…McCubbin et al concluded from their recent study about modeling sodium requirements that targeted sodium replacements may be unnecessary in elite marathoners [17]. Moreover, Fitzpatrick et al discovered in a 9-year retrospective study an association between a collapse and serum creatinine and electrolyte concentrations in marathon runners [18]. Furthermore, evidence synthesis regarding the risk factors for EAH is warranted.…”

Section: Introductionmentioning

confidence: 99%

Exercise-Associated Hyponatremia in Marathon Runners

Klingert

Nikolaidis

Weiss

et al. 2022

JCM

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Exercise-associated hyponatremia (EAH) was first described as water intoxication by Noakes et al. in 1985 and has become an important topic linked to several pathological conditions. However, despite progressive research, neurological disorders and even deaths due to hyponatremic encephalopathy continue to occur. Therefore, and due to the growing popularity of exercise-associated hyponatremia, this topic is of great importance for marathon runners and all professionals involved in runners’ training (e.g., coaches, medical staff, nutritionists, and trainers). The present narrative review sought to evaluate the prevalence of EAH among marathon runners and to identify associated etiological and risk factors. Furthermore, the aim was to derive preventive and therapeutic action plans for marathon runners based on current evidence. The search was conducted on PubMed, Scopus and Google Scholar using a predefined search algorithm by aggregating multiple terms (marathon run; exercise; sport; EAH; electrolyte disorder; fluid balance; dehydration; sodium concentration; hyponatremia). By this criterion, 135 articles were considered for the present study. Our results revealed that a complex interaction of different factors could cause EAH, which can be differentiated into event-related (high temperatures) and person-related (female sex) risk factors. There is variation in the reported prevalence of EAH, and two major studies indicated an incidence ranging from 7 to 15% for symptomatic and asymptomatic EAH. Athletes and coaches must be aware of EAH and its related problems and take appropriate measures for both training and competition. Coaches need to educate their athletes about the early symptoms of EAH to intervene at the earliest possible stage. In addition, individual hydration strategies need to be developed for the daily training routine, ideally in regard to sweat rate and salt losses via sweat. Future studies need to investigate the correlation between the risk factors of EAH and specific subgroups of marathon runners.

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Association between collapse and serum creatinine and electrolyte concentrations in marathon runners: a 9-year retrospective study

Cited by 4 publications

References 51 publications

Reliability of Biomarkers of Physiological Stress at Rest and Post-exertional Heat Stress

Reliability of Biomarkers of Physiological Stress at Rest and Post-exertional Heat Stress

Changes in blood test findings in participants in public running events

Exercise-Associated Hyponatremia in Marathon Runners

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