Prevalence of hyponatremia, renal dysfunction, and other electrolyte abnormalities among runners before and after completing a marathon or half marathon

Michael Mohseni, Scott Silvers, Rebecca Mcneil, Nancy Diehl, Tyler Vadeboncoeur, Walt Taylor, Shane A Shapiro, Jennifer Roth, Sherry Mahoney

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Prior reports on metabolic derangements observed in distance running frequently have small sample sizes, lack prerace laboratory measures, and report sodium as the sole measure. Hypothesis: Metabolic abnormalities-hyponatremia, hypokalemia, renal dysfunction, hemoconcentration-are frequent after completing a full or half marathon. Clinically significant changes occur in these laboratory values after race completion. Study Design: Observational, cross-sectional study. Methods: Consenting marathon and half marathon racers completed a survey as well as finger stick blood sampling on race day of the National Marathon to Fight Breast Cancer (Jacksonville, Florida, February 2008). Parallel blood measures were obtained before and after race completion (prerace, n = 161; postrace, n = 195). Results: The prevalence of prerace and postrace hyponatremia was 8 of 161 (5.0%) and 16 of 195 (8.2%), respectively. Hypokalemia was not present prerace but was present in 1 runner postrace (1 of 195). Renal dysfunction occurred prerace in 14 of 161 (8.7%) and postrace in 83 of 195 (42.6%). Among those with postrace renal dysfunction, 45.8% (38 of 83) were classified as moderate or severe. Hemoconcentration was present in 2 of 161 (1.2%) prerace and 6 of 195 (3.1%) postrace. The mean changes in laboratory values were (postrace minus prerace): sodium, 1.6 mmol/L; potassium, -0.2 mmol/L; blood urea nitrogen, 2.8 mg/dL; creatinine, 0.2 mg/dL; and hemoglobin, 0.3 g/dL for 149 pairs (except blood urea nitrogen, n = 147 pairs). Changes were significant for all comparisons (P < 0.01) except potassium (P = 0.08) and hemoglobin (P = 0.01). Conclusions: Metabolic abnormalities are common among endurance racers, and they may be present prerace, including hyponatremia. The clinical significance of these findings is unknown. Clinical relevance: It is unclear which runners are at risk for developing clinically important metabolic derangements. Participating in prolonged endurance exercise appears to be safe in the majority of racers.

Original languageEnglish (US)
Pages (from-to)145-151
Number of pages7
JournalSports Health
Volume3
Issue number2
DOIs
StatePublished - Mar 2011

Fingerprint

Hyponatremia
Electrolytes
Hypokalemia
Blood Urea Nitrogen
Kidney
Potassium
Sodium
Sample Size
Fingers
Observational Studies
Creatinine
Hemoglobins
Cross-Sectional Studies
Exercise
Breast Neoplasms

Keywords

  • Endurance sports
  • Hyponatremia
  • Marathon
  • Renal dysfunction
  • Running

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Prevalence of hyponatremia, renal dysfunction, and other electrolyte abnormalities among runners before and after completing a marathon or half marathon. / Mohseni, Michael; Silvers, Scott; Mcneil, Rebecca; Diehl, Nancy; Vadeboncoeur, Tyler; Taylor, Walt; Shapiro, Shane A; Roth, Jennifer; Mahoney, Sherry.

In: Sports Health, Vol. 3, No. 2, 03.2011, p. 145-151.

Research output: Contribution to journalArticle

Mohseni, Michael ; Silvers, Scott ; Mcneil, Rebecca ; Diehl, Nancy ; Vadeboncoeur, Tyler ; Taylor, Walt ; Shapiro, Shane A ; Roth, Jennifer ; Mahoney, Sherry. / Prevalence of hyponatremia, renal dysfunction, and other electrolyte abnormalities among runners before and after completing a marathon or half marathon. In: Sports Health. 2011 ; Vol. 3, No. 2. pp. 145-151.
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AU - Diehl, Nancy

AU - Vadeboncoeur, Tyler

AU - Taylor, Walt

AU - Shapiro, Shane A

AU - Roth, Jennifer

AU - Mahoney, Sherry

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N2 - Background: Prior reports on metabolic derangements observed in distance running frequently have small sample sizes, lack prerace laboratory measures, and report sodium as the sole measure. Hypothesis: Metabolic abnormalities-hyponatremia, hypokalemia, renal dysfunction, hemoconcentration-are frequent after completing a full or half marathon. Clinically significant changes occur in these laboratory values after race completion. Study Design: Observational, cross-sectional study. Methods: Consenting marathon and half marathon racers completed a survey as well as finger stick blood sampling on race day of the National Marathon to Fight Breast Cancer (Jacksonville, Florida, February 2008). Parallel blood measures were obtained before and after race completion (prerace, n = 161; postrace, n = 195). Results: The prevalence of prerace and postrace hyponatremia was 8 of 161 (5.0%) and 16 of 195 (8.2%), respectively. Hypokalemia was not present prerace but was present in 1 runner postrace (1 of 195). Renal dysfunction occurred prerace in 14 of 161 (8.7%) and postrace in 83 of 195 (42.6%). Among those with postrace renal dysfunction, 45.8% (38 of 83) were classified as moderate or severe. Hemoconcentration was present in 2 of 161 (1.2%) prerace and 6 of 195 (3.1%) postrace. The mean changes in laboratory values were (postrace minus prerace): sodium, 1.6 mmol/L; potassium, -0.2 mmol/L; blood urea nitrogen, 2.8 mg/dL; creatinine, 0.2 mg/dL; and hemoglobin, 0.3 g/dL for 149 pairs (except blood urea nitrogen, n = 147 pairs). Changes were significant for all comparisons (P < 0.01) except potassium (P = 0.08) and hemoglobin (P = 0.01). Conclusions: Metabolic abnormalities are common among endurance racers, and they may be present prerace, including hyponatremia. The clinical significance of these findings is unknown. Clinical relevance: It is unclear which runners are at risk for developing clinically important metabolic derangements. Participating in prolonged endurance exercise appears to be safe in the majority of racers.

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