Biphasic Pattern of Exercise-Induced Proteinuria in Sedentary and Trained Men

Şentürk, Ümit Kemal; Kuru, Oktay; Koçer, Günnur; Gündüz, Filiz

doi:10.1159/000097953

Cited by 17 publications

(15 citation statements)

References 53 publications

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“…The mechanisms postulated for glomerular proteinuria are changes in glomerular hemodynamics and in basal glomerular membrane permeability (13)(14)(15). Proteinuria disappeared after drumming in all of the individuals with RU.…”

Section: Discussionmentioning

confidence: 97%

Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular Hemolysis

Tobal¹,

Olascoaga²,

Moreira³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: During Carnival, groups of >60 drummers go drumming with their hands and marching for periods of 2 to 4 h. The objective of this study was to determine the frequency and type of urinary abnormalities after candombe drumming and to evaluate possible pathogenic mechanisms.Design, setting, participants, & measurements: For analysis of pathogenic mechanisms, a group of individuals were prospectively evaluated before and after candombe drumming.Methods: Candombe drummers were recruited in January 2006, 1 wk before prolonged drumming. After clinical evaluation, urine and blood samples were obtained before and immediately after drumming.Results: Forty-five healthy individuals (four women and 41 men), median age 31 yr (14 to 56), were evaluated. Predrumming urine and plasma samples were obtained for 30 individuals. Nineteen (42%) of 45 had a previous history of rust urine emission temporally related with candombe drumming. After drumming, 18 of 26 showed urine abnormalities; six of 26 showed rust urine, eight of 26 had microhematuria, and seven of 26 had proteinuria >1 g/L. The candombe drummers who showed rust urine after heavy drumming presented significantly higher levels of lactate dehydrogenase and total bilirubin when compared with those without urine abnormalities. Haptoglobin was significantly lower in the rust urine group. Fragmented red cells were observed in the blood smear of individuals with rust urine. Rust urine after drumming was associated with previous episodes of rust urine and glucosuria.Conclusions: Taken together, these data confirm that rust urine is caused by extracorpuscular hemolysis.

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Section: Discussionmentioning

confidence: 97%

Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular Hemolysis

Tobal¹,

Olascoaga²,

Moreira³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…Exercise related to oxidative stress was said to be a contributory factor to incidence of post-exercise proteinuria (31,32). Therefore, levels of H-FABP with a molecular weight of 15kDa were likely significantly decreased in both groups due to exercise-induced proteinuria.…”

Section: Discussionmentioning

confidence: 99%

Relationship between heart-type fatty acid-binding protein levels and coronary artery disease in exercise stress testing: an observational study

Arı¹,

Tokaç²,

Alihanoğlu³

et al. 2011

Anadolu Kardiyol Derg

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Objective: Although, there has been great improvement on the diagnosis and early treatment of acute coronary syndromes, especially in terms of myocardial damage biochemical markers, we do not have a specific marker yet, for using the diagnosis of stable coronary artery disease (CAD). This study aimed to evaluate the relationship between CAD and the changes of heart-type fatty acid binding protein (H-FABP) levels before and after exercise stress testing (EST). Methods: A total of 47 patients were enrolled in this observational study. Of 47 patients, 21 had normal coronary anatomy; the remaining 26 patients had coronary lesions over 70% in at least one major coronary artery. All patients performed EST. Along with this, H-FABP levels before EST and at peak exercise, 1 st hour, 3 rd hour (3h), were measured in all patients. Differences among the measurements were evaluated through the Friedman test and Wilcoxon test, and the Bonferroni correction was applied to determine which measurement caused the difference. Results: Contrary to expectations, the means of the H-FABP values measured at particular intervals for each group tended to decline from the basal level to the 3h level. When the difference between the 3h measurement and the basal level was compared in each group, the decreasing was statistically significant in both groups (p<0.05). A statistically significant decrease at the 3h measurement compared to the basal level in the CAD group was more apparent than in the control group (2.790±2.569ng/ml vs. 0.837±2.070ng/ml, p=0.009). Conclusion: We found that H-FABP levels did not increase during EST and contrary to expectation, were inclined to decrease. We thought that decreasing H-FABP levels likely resulted from exercise-induced proteinuria. (Anadolu Kardiyol Derg 2011; 11: 685-91) Key words: Coronary artery disease, heart-type fatty acid binding protein, exercise stress testing 685 ÖZET Amaç: Akut koroner sendrom tanısı ve erken tedavisinde özellikle miyokardiyal hasar belirteçlerinde sağlanan ilerleme ile önemli bir mesafe alınmasına rağmen stabil koroner arter hastalığı (KAH) tanısında kullanılabilecek özel bir markır henüz yoktur. Bu çalışmada egzersiz stres testi (EST) öncesi ve sonrası H-FABP düzeylerindeki değişim ile koroner arter hastalığı arasındaki ilişki araştırılmıştır. Yöntemler: Gözlemsel çalışmamıza en az bir majör koroner arterinde %70 ve üzerinde darlığı olan 26 hasta ve koroner arterleri normal bulunan 21 hasta olmak üzere toplam 47 hasta alındı. Tüm hastalara EST yapıldı. Tüm hastalarda bazal, pik egzersiz, 1. saat ve 3. saatte H-FABP ölçümü yapıldı. Ölçümler arası farka Friedman Testi ile bakıldı, farkın hangi ölçümden kaynaklandığını bulmak için Bonferroni düzeltmeli Wilcoxon Testi kullanıldı. Bulgular: Her bir grupta belirlenen zaman aralığında ölçülen H-FABP değerleri ortalamaları beklenenin aksine bazaldan üçüncü saate azalma eğiliminde idi. Üçüncü saat ile bazal ölçümler arasındaki farklar (fark 3) grup içinde karşılaştırıldığında her iki grupta da azalma anlamlı idi (p<0.05). H...

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“…In this present study, we measured total urinary protein excretion without assessing the glomerular or tubular component. It is well known that during mild to moderate exercise, the proteinuria that occurs is the glomerular type, but when exhaustive exertion is involved, the postexercise proteinuria seems to be of a mixed glomerular-tubular type (24,26,31). It is possible that XO enzyme inhibition may improve the tubular component of exercise-induced proteinuria as measured by low-molecular weight proteins such as ␤ 2 -microglobulin in urine.…”

Section: Xo Studymentioning

confidence: 99%

“…However, the transient effects of exercise on renal function are incapable of explaining the proteinuria that occurs 24 -48 h after exercise. In addition to these mechanisms, our previous studies established that exercise-induced oxidative stress also contributes to the occurrence of postexercise proteinuria in both rats (6) and humans (31). However, the sources of oxidative stress that induce urinary protein excretion after exercise are still unknown.…”

mentioning

confidence: 99%

Potential sources of oxidative stress that induce postexercise proteinuria in rats

Kocer¹,

Şentürk²,

Kuru³

et al. 2008

Journal of Applied Physiology

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Exercise-induced proteinuria is a common consequence of physical activity and is caused predominantly by alterations in renal hemodynamics. Although it has been shown that exercise-induced oxidative stress can also contribute to the occurrence of postexercise proteinuria, the sources of reactive oxygen species that promote it are unknown. We investigated the enzymes nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and xanthine oxidase (XO) as possible sources of oxidative stress in postexercise proteinuria. First, we evaluated the effect of blocking the NADPH oxidase enzyme on postexercise proteinuria. We found a significant increase in urinary protein level, kidney thiobarbituric acid-reactive substances (TBARS), and protein carbonyl content after exhaustive exercise, and NADPH oxidase activity was induced by exercise. Rats that were treated with an NADPH oxidase inhibitor for 4 days before exhaustive exercise showed no increase in kidney TBARS or protein carbonyl derivative level and no proteinuria or NADPH oxidase activation. In the next set of experiments, we investigated the effect of XO blockage on postexercise proteinuria. Oxypurinol, an XO inhibitor was administered to rats for 3 days before exercise. Although XO inhibition significantly decreased kidney TBARS levels and protein carbonyl content in exercised rats, the inhibition did not prevent exercise-induced proteinuria. However, plasma and kidney XO activity was not induced by exercise, but rather it was suppressed under oxypurinol treatment. These results suggest that increased NADPH oxidase activity induced by exhaustive exercise is an important source of elevated oxidative, stress during exercise, which contributes to the occurrence of postexercise proteinuria.

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Biphasic Pattern of Exercise-Induced Proteinuria in Sedentary and Trained Men

Cited by 17 publications

References 53 publications

Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular Hemolysis

Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular Hemolysis

Relationship between heart-type fatty acid-binding protein levels and coronary artery disease in exercise stress testing: an observational study

Potential sources of oxidative stress that induce postexercise proteinuria in rats

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