Proteinuria in a high-altitude 161-km (100-mile) ultramarathon

Khodaee, Morteza; Saeedi, Anahita; Irion, Bjørn; Spittler, Jack; Hoffman, Martin D.

doi:10.1080/00913847.2020.1782153

Cited by 10 publications

(9 citation statements)

References 38 publications

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“…The means and ranges of other electrolytes post-race among the runners are summarized in Table 5. Results from other blood and urine tests are reported in detail in our pre-vious studies [20][21][22][23] . Based on the electronic survey conducted 1-2 weeks after the race, none of the athletes whose blood samples were collected visited an emergency department or a physician's office after the race.…”

Section: Resultsmentioning

confidence: 99%

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Incidence of exercise-associated hyponatremia during a high-altitude 161-km ultramarathon

Khodaee

Saeedi²,

Harris-Spinks

et al. 2021

Phys Act Nutr

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[Purpose] Exercise-associated hyponatremia (EAH) is a well-known condition among endurance athletes at low altitudes. The incidence of EAH during ultramarathons at high altitudes warrants further investigation. This prospective observational study was conducted on the participants of the Leadville Trail 100 run, a 161- km race held at a high altitude (2,800 m-3,840 m).[Methods] Venous blood samples were collected before and immediately after the race. The participants completed an electronic survey after the race. Our main outcome measure was the post-race serum sodium ([Na+]) level.[Results] Of the 672 athletes who started the race, 351 (52%) successfully completed the event within the 30- hour cut-off. Post-race blood samples were collected from 84 runners (66 finishers). Both pre- and post-race blood samples were collected from 37 participants. Twenty percent of the post-race participants had EAH. Only one post-race participant had a [Na+] level of <130 mmol/L. All participants with EAH were asymptomatic. One participant had an abnormal pre-race [Na+] level (134 mmol/L). Female participants had a significantly higher rate of EAH than male participants (40% vs. 16%; p=0.039). Age, body mass index, weight changes, race completion status, nonsteroidal anti-inflammatory drug use, and urine specific gravity were not associated with the development of EAH. Lower postrace [Na+] levels were associated with higher serum creatine kinase values (R2=0.1, p<0.005).[Conclusion] High altitude (3,840 m peak) does not appear to enhance the incidence of EAH after an ultramarathon footrace. This suggests that ambient temperature (low temperatures reduce risk), sex (female predilection), endurance running, and overhydration are more prominent risk factors for EAH than high altitude.

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Section: Resultsmentioning

confidence: 99%

“…We collected both pre- and post-race blood samples from 37 runners. Information on urine analysis has been published elsewhere [ 20 ]. There was no compensation for participating in the study; however, the athletes were informed about their test results.…”

Section: Methodsmentioning

confidence: 99%

Incidence of exercise-associated hyponatremia during a high-altitude 161-km ultramarathon

Khodaee

Saeedi²,

Harris-Spinks

et al. 2021

Phys Act Nutr

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“…While this is consistent with female participation rates in ultramarathons, 35 it is likely too small of a sample size from which we can draw definitive conclusions about AKI risk related to sex. Another limitation of our study with multiple data points and measurement 23‐25 is the risk of false positive findings and type 1 error 39 …”

Section: Discussionmentioning

confidence: 99%

“…Information on methodology and other analyses of this study is available elsewhere 24,25 . Results from urine analysis are presented in another paper 23 …”

Section: Methodsmentioning

confidence: 99%

“…The data collected for the present paper were part of a wider study with three aims: 1) determine whether post‐race urine dipstick testing is useful in the early post‐race identification of athletes at risk for AKI following completion of a 100‐mile ultramarathon 23 ; 2) investigate any possible correlation between athlete demographic characteristics (eg, acclimatization pattern) and risk for AKI; and 3) identify any possible correlation between race time and variations in urine dipstick and metabolic biomarkers 23‐25 . The aim of this particular paper was a part of aim 2.…”

Section: Introductionmentioning

confidence: 99%

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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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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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Proteinuria in a high-altitude 161-km (100-mile) ultramarathon

Cited by 10 publications

References 38 publications

Incidence of exercise-associated hyponatremia during a high-altitude 161-km ultramarathon

Incidence of exercise-associated hyponatremia during a high-altitude 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

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