Hyponatremia in runners requiring on-site medical treatment at a single marathon

Hsieh, Margaret; Roth, Ronald N.; Davis, Devon L; Larrabee, Hollynn; Callaway, Clifton W.

doi:10.1097/00005768-200202000-00001

Cited by 48 publications

(33 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…50,57,58,142,144 The early signs of EAH include headache, dizziness, physical exhaustion, muscular twitching, and nausea, all of which are also symptoms of hypohydration. Differential signs and symptoms of EAH due to fluid retention include weight gain, history of overdrinking, extremity swelling, and progressively worsening headache.…”

Section: Recognition Of Hypohydration and Fluid Overloadmentioning

confidence: 99%

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

McDermott

Anderson

Armstrong

et al. 2017

Journal of Athletic Training

285

304

View full text Add to dashboard Cite

Objective: To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals.Background: Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prevent hypohydration during physical activity but must be aware of the risks of overdrinking and hyponatremia. Drinking behavior can be modified by education, accessibility, experience, and palatability. This statement updates practical recommendations regarding fluidreplacement strategies for physically active individuals.Recommendations: Educate physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity.

show abstract

Section: Recognition Of Hypohydration and Fluid Overloadmentioning

confidence: 99%

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

McDermott

Anderson

Armstrong

et al. 2017

Journal of Athletic Training

285

304

View full text Add to dashboard Cite

show abstract

“…Of 15 marathon runners hospitalized with severe hyponatremia, 28.6% used NSAIDs (Davis et al 2001). In contrast, other observational studies have found no relationship between NSAIDs and hyponatremia (Hsieh et al 2002;Almond et al 2005;Scotney and Reid 2015). One inherent issue with existing literature is not knowing the NSAID type or dosage.…”

Section: Fluid and Electrolyte Balancementioning

confidence: 99%

“…Despite this information, few studies have examined this relationship, with most being observational studies with conflicting results (Davis et al 2001;Hsieh et al 2002;Almond et al 2005;Wharam et al 2006). Ultra-distance triathletes using NSAIDs had significantly lower post-race P[Na + ] compared with non-NSAID users (Wharam et al 2006).…”

Section: Fluid and Electrolyte Balancementioning

confidence: 99%

Effects of a 24-h naproxen dose on hydration and electrolyte measures during moderate-intensity cycling in the heat

Emerson

Torres-McGehee

Davis

et al. 2017

FACETS

View full text Add to dashboard Cite

Few controlled laboratory studies have examined the negative effects non-steroidal anti-inflammatory drugs can have on fluid-electrolyte balance during exercise. Our objective was to determine whether a 24-h naproxen dose negatively affected hydration and electrolyte measures before, during, and 3 h after 90 min of cycling in a hot or ambient environment. Using a double blind, randomized and counterbalanced cross-over design, 11 volunteers (six male, five female) completed four trials, with conditions as follows: (1) placebo and ambient, (2) placebo and heat, (3) naproxen and ambient, and (4) naproxen and heat. We found no statistically significant differences among experimental conditions for any dependent measures. Though not statistically significant, mean fluid volume was higher and urine volume was lower during naproxen trials compared with placebos. Mean aggregate plasma sodium was <135 mmol/L at all time points and did not significantly change over time. Overall plasma potassium significantly increased pre-(3.9 ± 0.4) to post-exercise (4.2 ± 0.4 mmol/L, p = 0.02). In conclusion, an acute naproxen dose did not significantly alter hydration-electrolyte balance. The trend for naproxen to increase fluid volume and decrease urine volume suggests the start of fluid retention, which should concern individuals at risk for hyponatremia or with pre-existing cardiovascular conditions.

show abstract

“…Nonsteroidal anti-inflammatory drug (NSAID) use is common among marathon runners, being used in 50 to 60% of men and women, respectively (10,22,47). NSAID are known to potentiate the effects of arginine vasopressin (AVP) by inhibiting renal prostaglandin synthesis via the COX-2 isoform of cyclo-oxygenase (48 -50).…”

Section: Risk Factorsmentioning

confidence: 99%

Exercise-Associated Hyponatremia

Rosner

Kirven

2007

Clinical Journal of the American Society of Nephrology

170

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

Hyponatremia in runners requiring on-site medical treatment at a single marathon

Abstract: This study found a 5.6% incidence of hyponatremia in marathon runners requiring medical treatment.

Cited by 48 publications

References 24 publications

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

Effects of a 24-h naproxen dose on hydration and electrolyte measures during moderate-intensity cycling in the heat

Exercise-Associated Hyponatremia

Contact Info

Product

Resources

About