Abstract
The stress of strenuous long-term exercise may alter renal function.
Whether this is also true for marathon cycling is unknown so far. The purpose
of this study was to evaluate renal function following competitive marathon
cycling. We investigated 38-male, well-trained recreational cyclists credibly
not taking any kind of doping who participated in the Ötztal Radmarathon.
Blood and urine specimens were taken the day before, immediately after and one
day after competition.
Baseline renal functional parameters - normal before competition -
increased significantly afterwards and remained elevated during 24 hours of
recovery. The rises in serum creatinine, urea and uric acid were 20, 54 and
42 % (p < 0.001 respectively). The corresponding
decline in estimated creatinine clearance was 18 %. In all
athletes the serum urea/creatinine ratio rose above 40, fractional sodium
excretion and fractional uric acid excretion fell below 0.4 % and
15 %, indicating reduced renal perfusion. The observed effects
lasted for at least 24 h despite a stable fluid balance during the race
and an expanding plasma volume (PV) in the recovery period. Levels of
haematocrit remained unchanged immediately post-race but significantly declined
from 0.44 to 0.41 on the following day (p < 0.001). The
calculated rise in PV was + 10.8 %. Electrolyte
homeostasis was preserved throughout the observation period. Post-exercise
proteinuria was small and of the mixed glomerular-tubular type. There was
neither evidence for exercise-induced haemolysis, nor for significant skeletal
muscle damage.
The finding obtained from well-hydrated recreational athletes
reveals that the extraordinary strains of marathon cycling influence renal
function only on a minimal scale. Though minor, the physiological effects were
long-lasting. The results obtained suggest that a reduced renal perfusion is
the mechanism responsible for the slight impairment of renal function following
exhaustive marathon cycling.
Key words
Renal hypoperfusion - endurance exercise - plasma volume expansion
References
- 1
Altenkirch H U, Gerzer R, Kirsch K A, Weil J, Heyduck B, Schultes I, Rocker L.
Effect of prolonged physical exercise on fluid regulating
hormones.
Eur J Appl Physiol.
1990;
61
209-213
- 2
Armstrong R B.
Muscle damage and endurance events.
Sports Med.
1986;
3
370-381
- 3
Castenfors J, Mossfeldt F, Piscator M.
Effect of prolonged heavy exercise on renal function and
urinary protein excretion.
Acta Physiol Scand.
1967;
70
194-206
- 4
Costill D L.
Sweating: its composition and effects on body fluids.
Ann N Y Acad Sci.
1977;
301
160-174
- 5
Dancaster C P, Duckworth W C, Roper C J.
Nephropathy in marathon runners.
S Afr Med J.
1969;
43
758-759
- 6
Dancaster C P, Whereat S J.
Renal function in marathon runners.
S Afr Med J.
1971;
45
547-551
- 7
Decombaz J, Reinhardt P, Anantharaman K, von Glutz G, Poortmans J R.
Biochemical changes in a 100 km run: free amino acids,
urea, and creatinine.
Eur J Appl Physiol.
1979;
41
61-72
- 8
Fallon K E, Sivyer G, Sivyer K, Dare A.
The biochemistry of runners in a 1600 km
ultramarathon.
Br J Sports Med.
1999;
33
264-269
- 9
Gault M H, Longerich L L, Harnett J D, Wesolowski C.
Predicting glomerular function from adjusted serum creatinine
[editorial].
Nephron.
1992;
62
249-256
- 10
Green H J, Fraser I G.
Differential effects of exercise intensity on serum uric acid
concentration.
Med Sci Sports Exerc.
1988;
20
55-59
- 11
Irving R A, Noakes T D, Burger S C, Myburgh K H, Querido D, van Zyl S R.
Plasma volume and renal function during and after
ultramarathon running [see comments].
Med Sci Sports Exerc.
1990;
22
581-587
- 12
Irving R A, Noakes T D, Irving G A, van Zyl S R.
The immediate and delayed effects of marathon running on
renal function.
J Urol.
1986;
136
1176-1180
- 13
Irving R A, Noakes T D, Raine R I, van Zyl S R.
Transient oliguria with renal tubular dysfunction after a
90 km running race.
Med Sci Sports Exerc.
1990;
22
756-761
- 14
Kreider R B.
Physiological considerations of ultraendurance
performance.
Int J Sport Nutr.
1991;
1
3-27
- 15
MacSearraigh E TM, Kallmeyer J, Schiff H B.
Acute renal failure in marathon runners.
Nephron.
1979;
24
236-240
- 16
Millard R W, Higgins C B, Franklin D, Vatner S F.
Regulation of the renal circulation during severe exercise in
normal dogs and dogs with experimental heart failure.
Circ Res.
1972;
31
881-888
- 17
Neviackas J A, Bauer J H.
Renal function abnormalities induced by marathon running.
.
South Med J.
1981;
74
1457-1460
- 18
Neumayr G, Pfister R, Mitterbauer G, Gaenzer H, Joannidis M, Eibl G, Hoertnagl H.
Short-term effects of prolonged strenuous endurance exercise
on the level of haematocrit in amateur cyclists.
Int J Sports Med.
2002;
23
158-161
- 19
Neumayr G, Pfister R, Mitterbauer G, Gaenzer H, Sturm W, Eibl G, Hoertnagl H.
Exercise intensity of cycle-touring events.
Int J Sports Med.
2002;
23
505-509
- 20
Ounpuu S.
The biomechanics of running: a kinematic and kinetic
analysis. Instr.
Course Lect.
1990;
39
305-318
- 21
Poortmans J R.
Exercise and renal function.
Sports Med.
1984;
1
125-153
- 22
Poortmans J R.
Postexercise proteinuria in humans. Facts and
mechanisms.
JAMA.
1985;
253
236-240
- 23
Poortmans J R, Brauman H, Staroukine M, Verniory A, Decaestecker C, Leclercq R.
Indirect evidence of glomerular/tubular mixed-type
postexercise proteinuria in healthy humans.
Am J Physiol.
1988;
254
F277-F283
- 24
Poortmans J R, Vancalck B.
Renal glomerular and tubular impairment during strenuous
exercise in young women.
Eur J Clin Invest.
1978;
8
175-178
- 25
Refsum H E, Stromme S B.
Relationship between urine flow, glomerular filtration, and
urine solute concentrations during prolonged heavy exercise.
Scand J Clin Lab Invest.
1975;
35
775-780
- 26
Refsum H E, Stromme S B.
Renal osmol clearance during prolonged heavy exercise.
Scand J Clin Lab Invest.
1978;
38
19-22
- 27
Schmidt W, Rojas J, Boning D, Bernal H, Garcia S, Garcia O.
Plasma-electrolytes in natives to hypoxia after marathon
races at different altitudes.
Med Sci Sports Exerc.
1999;
31
1406-1413
- 28
Steiner R W.
Interpreting the fractional excretion of sodium.
Am J Med.
1984;
77
699-702
- 29
Strauss M B, Davies R K, Rosenbaum J D, Rossmeisl E C.
Water diuresis produced during recumbency by the intravenous
infusion of isotonic saline solution.
J Clin Invest.
1951;
30
862-868
- 30
Suzuki M, Sudoh M, Matsubara S, Kawakami K, Shiota M, Ikawa S.
Changes in renal blood flow measured by radionuclide
angiography following exhausting exercise in humans.
Eur J Appl Physiol.
1996;
74
1-7
- 31
Virvidakis C, Loukas A, Mayopoulou-Symvoulidou M, Mountokalakis T.
Renal responses to bicycle exercise in trained athletes:
influence of exercise intensity.
Int J Sports Med.
1986;
7
86-88
- 32
West M L, Marsden P A, Richardson R M, Zettle R M, Halperin M L.
New clinical approach to evaluate disorders of potassium
excretion.
Miner Electrolyte Metab.
1986;
12
234-238
- 33
Williams K R.
The relationship between mechanical and physiological energy
estimates.
Med Sci Sports Exerc.
1985;
17
317-325
G. Neumayr, MD
Institute of Sports Medicine, University Clinics of
Innsbruck
Anichstraße 35 · 6020 Innsbruck · Austria
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Phone: (+39) 0474 917171
Fax: (+39) 0474 917111
Email: guenther.neumayr@sb-bruneck.it