Glomerular Filtration Rate Is Unchanged by Ultramarathon

Wołyniec, Wojciech; Ratkowski, Wojciech; Kasprowicz, Katarzyna; Jastrzębski, Zbigniew; Małgorzewicz, Sylwia; Witek, Konrad; Grzywacz, Tomasz; Żmijewski, Piotr; Renke, Marcin

doi:10.1519/jsc.0000000000002348

Cited by 13 publications

(15 citation statements)

References 40 publications

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“…This work demonstrates that, depending on the methodology used, AKI criteria was met by 21%‐63% of the subjects following the ultramarathon. This is consistent with prior work demonstrating a 25%‐80% incidence of the criteria being met during ultramarathons of various distances 11,14,30,31 . The implications of such high incidents of AKI criteria being met are not clear, but the current belief is that there is no reason for concern about long‐term harm to the kidneys in ultramarathon runners 31,32 .…”

Section: Discussionsupporting

confidence: 87%

Characteristics of runners meeting acute kidney injury criteria following a 161‐km ultramarathon

Khodaee

Irion²,

Spittler

et al. 2021

Translational Sports Med

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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.

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Section: Discussionsupporting

confidence: 87%

Characteristics of runners meeting acute kidney injury criteria following a 161‐km ultramarathon

Khodaee

Irion²,

Spittler

et al. 2021

Translational Sports Med

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“…Besides, severe cases of AKI in non-runners may require dialysis and are especially vulnerable to worse long-term renal outcomes [ 154 ]. Occasionally, AKI is detected in combination with rhabdomyolysis that may lead to a more complex condition in UER [ 144 , 155 – 157 ]. It is currently unknown if severe renal dysfunction in UER, or repetitive renal insults that meet the criteria of AKI, lead to an accelerated progression of long-term renal issues in UER [ 134 , 145 , 147 , 158 ].…”

Section: Long-term Health Implications: Key Aspects By Organ Systemmentioning

confidence: 99%

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Scheer¹,

Tiller

Doutreleau

et al. 2021

Sports Med

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It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.

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“…Therefore, whether ultra-marathon running by itself increases the risk of acute kidney injury need to be clarified. Some recent studies have shown an unchanged glomerular filtration rate by ultramarathon (Wołyniec et al, 2018), or no evidence that prior acute kidney injury caused greater renal dysfunction from a subsequent exercise stimulus (Hoffman and Weiss, 2016). We wanted to test the hypothesis that in common conditions (no use of NSAIDs and no major risk of dehydration), ultra-distance race has no supplemental short-term impact on acute kidney function.…”

Section: Introductionmentioning

confidence: 99%

Ultramarathon and Renal Function: Does Exercise-Induced Acute Kidney Injury Really Exist in Common Conditions?

Poussel

Touzé²,

Allado

et al. 2020

Front. Sports Act. Living

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Glomerular Filtration Rate Is Unchanged by Ultramarathon

Cited by 13 publications

References 40 publications

Characteristics of runners meeting acute kidney injury criteria following a 161‐km ultramarathon

Characteristics of runners meeting acute kidney injury criteria following a 161‐km ultramarathon

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Ultramarathon and Renal Function: Does Exercise-Induced Acute Kidney Injury Really Exist in Common Conditions?

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