NSAID Use Increases the Risk of Developing Hyponatremia during an Ironman Triathlon

Wharam, Paul C; Speedy, Dale B.; Noakes, Timothy D.; Thompson, John M. D.; Reid, Sean D.; Holtzhausen, Lucy‐May

doi:10.1249/01.mss.0000210209.40694.09

Cited by 132 publications

(125 citation statements)

References 35 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…A etiologia deste distúrbio ainda é controversa. Contudo, há algumas considerações mais plausíveis como a sobrecarga da ingestão hídrica com reposição insuficiente de sódio, atividade inapropriada do hormônio antidiurético (12)(13)(14) , seqüestro de sódio para o intestino (terceiro espaço), perda de sódio excessiva no suor, insuficiência renal em eliminar o excesso de líquido (15) , associado ou não ao uso de antiinflamatórios não hormonais (38) . Dentre todas essas possibilidades o excesso de ingestão hídrica associada ou não a outros fatores parece ser a principal causa da hiponatremia em atletas de triatlon Ironman.…”

Section: Discussionunclassified

Alterações hidroeletrolíticas agudas ocorridas no Triatlon Ironman Brasil

Mara

Lemos

Brochi

et al. 2007

Rev Bras Med Esporte

View full text Add to dashboard Cite

ARTIGO ORIGINALPalavras-chave: Hiponatremia. Desidratação. Superhidratação. Potássio. Keywords:Hyponatremia. Dehydration. Superhydration. Potassium. RESUMOO Triatlon Ironman caracteriza-se por ser uma atividade de resistência constituída por 3,8km de natação, 180km de ciclismo e 42,2km de corrida, no qual o atleta exercita-se, em média, por cerca de 13 horas. Neste contexto, o atleta exposto a tal carga de esforço e adversidades ambientais, experimenta alterações orgâ-nicas agudas em seus sistemas biológicos, incluindo os distúr-bios hidroeletrolíticos. O objetivo deste estudo é descrever as alterações hídricas e eletrolíticas encontradas em atletas de triatlon Ironman. De 2002 a 2005 foram avaliados 109 atletas voluntários antes e imediatamente após as provas realizadas em Florianópo-lis-SC Brasil, com análise sanguínea dos eletrólitos sódio, e potás-sio, e medida de massa corporal. Os dados do sódio sérico de 89 atletas foram correlacionados com o grau de desidratação e modificações percentuais de peso corporal. Dados de 77 atletas, quanto ao potássio sérico, foram avaliados isoladamente de forma descritiva. Seis atletas (6,7%) apresentaram-se euhidratados ou superhidratados ao final da prova, 50 atletas desidrataram de 0 a 3% (56,2%), 29 de 3 a 6% (32,6%) e 4 atletas (4,5%) desidrataram mais que 6%. Houve uma tendência a ocorrer hiponatremia entre aqueles que desidrataram menos ou ganharam peso. O potássio teve um comportamento dentro dos limites da normalidade em toda amostra. Conclui-se que os distúrbios hidroeletrolíticos (hiponatremia e desidratação) são incidentes nesta modalidade esportiva, sendo a superhidratação a etiologia provável da hiponatremia denotada pelo ganho ou perdas discretas de peso. ABSTRACT Acute hydroelectrolytic changes occurred in the Brazilian Ironman TriathlonThe Ironman Triathlon is characterized for being an endurance activity consisting of 3.8 km of swimming, 180 km of cycling and 42.2 km of running, in which the athlete exercises an average of about 13 hours. In this context, the athlete exposed to such load of effort and environmental adversities, experiences acute organic alterations in his biological systems, including hydroelectrolytic disturbs. The objective of this study is to describe the hydric and electrolytic alterations found in Ironman triathlon athletes. From years 2002 to 2005, 109 volunteer athletes have been evaluated before and immediately after the events which took place in Florianópolis-SC Brazil, with blood analysis of sodium and potassium electrolytes, and body mass measurement. Sodium serum data from 89 athletes have been correlated with the degree of dehydration and percentage alterations of body weight. Data of 77 athletes concerning the serum potassium were separately evaluated in a descriptive way. Six athletes (6.7%) were euhydrated or superhydrated at the end of the test; 50 athletes were dehydrated from 0 to 3% (56.2%); 29 from 3 to 6 % (32.6%) and 4 athletes (4.5%) were dehydrated more than 6%. There was a tendency to hyponatremia among those who ...

show abstract

Section: Discussionunclassified

Alterações hidroeletrolíticas agudas ocorridas no Triatlon Ironman Brasil

Mara

Lemos

Brochi

et al. 2007

Rev Bras Med Esporte

View full text Add to dashboard Cite

show abstract

“…Several studies have examined the incidence of hyponatremia in this cohort, and a range of 6 to 30% of these athletes had serum sodium values below normal (9,10,12,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). The wide range of incidence likely reflects differences in fluid replacement guidelines that were prevalent at the time and place of the study.…”

Section: Clinical Featuresmentioning

confidence: 96%

“…However, recent studies have shown that endurance athletes not uncommonly develop hyponatremia at the end of the race, usually in the absence of clear central nervous system symptoms (9,10,12,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). For example, in the 2002 Boston Marathon, Almond et al (15) found that 13% of 488 runners studied had hyponatremia (defined as a serum sodium concentration of 135 mmol/L or less) and 0.6% had critical hyponatremia (serum sodium concentration of 120 mmol/L or less).…”

Section: Incidencementioning

confidence: 99%

“…Other studies also have not been able to ascribe conclusively to NSAID use the development of hyponatremia, although several of these studies were underpowered to do so (10,22). However, a recent study in 330 triathletes demonstrated a significant association of NSAID use and the development of hyponatremia (23). In this study, the incidence of NSAID use in athletes was 30%, and NSAID use was highly associated with the development of hyponatremia (P ϭ 0.0002), as well as higher plasma potassium and creatinine levels.…”

Section: Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Exercise-Associated Hyponatremia

Rosner

Kirven

2007

Clinical Journal of the American Society of Nephrology

165

View full text Add to dashboard Cite

Exercise-associated hyponatremia has been described after sustained physical exertion during marathons, triathlons, and other endurance athletic events. As these events have become more popular, the incidence of serious hyponatremia has increased and associated fatalities have occurred. The pathogenesis of this condition remains incompletely understood but largely depends on excessive water intake. Furthermore, hormonal (especially abnormalities in arginine vasopressin secretion) and renal abnormalities in water handling that predispose individuals to the development of severe, life-threatening hyponatremia may be present. This review focuses on the epidemiology, pathogenesis, and therapy of exercise-associated hyponatremia.

show abstract

“…One initiative put in place by both New Zealand and South African Ironman races, has been to reduce the number of drink stations available on the course, to lower the opportunity to drink. This action has successfully lessened the occurrence of hyponatremia in long distance triathlon racing, and is an action that should be followed by long distance triathlon race organizers throughout the world (Sharwood et al, , 2004Wharam et al, 2006).…”

Section: Drinking Guidelines For Long Distance Triathletesmentioning

confidence: 99%

Long distance triathlon: demands, preparation and performance

Laursen¹

2011

JHSE

View full text Add to dashboard Cite

Laursen PB. Long distance triathlon: demands, preparation and performance. J. Hum. Sport Exerc. Vol. 6, No. 2, pp. 247-263, 2011. The rise in worldwide popularity of long distance triathlon racing comes with it an increased interest into how to train and prepare optimally for such an event. This paper examines the physiologic and bioenergetic demands of long distance triathlon racing, including energy requirements, muscle damage consequences, thermoregulatory demands and water turnover rates. In response to these physiological challenges, the second part of the paper describes the training goals and race practices that may assist to minimize these disturbances, in turn, optimizing performance and health for the long distance triathlete. Some of these race strategies include appropriate pacing, ensuring adequate fluid and carbohydrate consumption, acclimating to the heat, and consuming caffeine in appropriate quantities.

show abstract

NSAID Use Increases the Risk of Developing Hyponatremia during an Ironman Triathlon

Cited by 132 publications

References 35 publications

Alterações hidroeletrolíticas agudas ocorridas no Triatlon Ironman Brasil

Alterações hidroeletrolíticas agudas ocorridas no Triatlon Ironman Brasil

Exercise-Associated Hyponatremia

Long distance triathlon: demands, preparation and performance

Contact Info

Product

Resources

About