The effect of exercise intensity on hematuria in healthy male runners

Abstract

The purpose of this study were: (1) to establish the prevalence of exercise-induced hematuria in a group of otherwise healthy male runners (n = 70), and (2) to investigate the role of exercise intensity in those runners who exhibited exercise-related hematuria (n = 10) by evaluating the effect of running and cycling at high and low intensities. The identified and recruited subjects participated in four different exercise protocols: (1) a 60-min treadmill run (RUN) at 90% of anaerobic threshold (Th(ae)), (2) a 60-min leg cycle ergometer ride (BIKE) at 90% of Th(ae), (3) a 3x400-m sprint (SPRINT), each followed by 4 min of rest or light walking, and (4) 3x60-Wingate leg cycle ergometry tests, each followed by 4 min of rest or light cycling. The study employed a 3x4 (time by protocol) within-subjects design and dependent variables were measured before exercise, 4 min after, and 1 h after exercise, and included measurements of hematuria, proteinuria, urinary pH, serum haptoglobin concentration, serum creatine phosphokinase activity, plasma lactate concentration, and hemoglobin. The 400-m sprint at maximal effort significantly increased both hematuria and proteinuria (P<0.01). Post-exercise hematuria for the SPRINT protocol was significantly different than that for the BIKE (P<0.01) and RUN (P<0.01) protocols. Due to the significant increase in hematuria and proteinuria following the SPRINT protocol, it was concluded that exercise-related changes in renal function were associated with weight-bearing exercise intensity rather than non-weight-bearing exercise duration.

Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones

“…Despite this, the body has no innate mechanism to replace the iron losses incurred by physical activity; thereby a sufficient dietary intake is essential for athletes in periods of heavy training. The mechanisms of exercise-induced iron loss include such processes as hemolysis, hematuria, sweating and gastrointestinal bleeding (Babic et al 2001;DeRuisseau et al 2002;McInnis et al 1998;Zoller and Vogel 2004), and may also now extend to inflammation and hormone activity, based on recent research (Roecker et al 2005).…”

“…Athletes are commonly diagnosed with iron deficiency, particularly those involved in endurance sports (Beard and Tobin 2000;Zoller and Vogel 2004). A number of exercise-generated mechanisms are proposed to influence the iron status of an athlete including hemolysis, hematuria, sweating and gastrointestinal bleeding (Babic et al 2001;DeRuisseau et al 2002;McInnis et al 1998;Zoller and Vogel 2004). It is possible that frequent losses of iron from such mechanisms over the duration of a training program or competitive season may negatively affect iron status.…”

Cumulative effects of consecutive running sessions on hemolysis, inflammation and hepcidin activity

“…Mechanisms such as hemolysis, hematuria, sweating, and gastrointestinal bleeding contribute to this disrupted metabolism of iron (Babić et al 2001;DeRuisseau et al 2002;McInnis et al 1998;Zoller and Vogel 2004). Additionally, recent attention has focused on the post-exercise activity of the ironregulatory hormone hepcidin, suggesting that up-regulation of this hormone may have a negative impact on the body's ability to recycle and absorb dietary iron (Peeling et al 2008a;Roecker et al 2005).…”

Post exertional hematuria

“…The incidence of 12% hematuria after the run seen in our study is more in tandem with that found in Israeli Air Force recruits (5%), 1 unlike the incidence of470% seen in hard core athletes like ultra marathoners, 3 long distance skiers or 45% in professional athletes. [9][10][11][12][13][14] All investigators have commented that post exertional hematuria subsides within 72 h. [2][3][4]12,16,18 However, 19% of our subjects had persistence of hematuria beyond 72 h, and three individuals continued to have hematuria beyond 14 days. On evaluation, they were found to have primary glomerular disease.…”

“…[9][10][11] Some workers have suggested acidosis and hypoxia-related glomerular injury as the cause [12][13][14][15] ; however, recent data suggest it to be originating from lower tract. [12][13][14][15] McInnis et al 16 observed that post exertional hematuria is greater after intense weight bearing exercise rather than long duration non weight bearing exercise like cycling. Falsetti et al, 9 Poortmans and Jeanloz 13 and Helzer et al 17 observed that the intensity of exercise correlated with urinary abnormalities.…”