Practical management of exercise-associated hyponatremic encephalopathy: The sodium paradox of non-osmotic vasopressin secretion

Clinical Journal of Sport Medicine

Volumn 18, Issue 4, 2008, Pages 350-354

  Hew Butler, Tamara ^a,b,d   Noakes, Timothy D ^a   Siegel, Arthur J ^c  

^a UNIVERSITY OF CAPE TOWN   (South Africa)

^b Systemic Inflammation Laboratory   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d ST JOSEPH'S HOSPITAL AND MEDICAL CENTER   (United States)

Author keywords

Arginine vasopressin; Hyponatremia; Sodium supplementation

Indexed keywords

ARGIPRESSIN; FUROSEMIDE; HYPERTONIC SOLUTION; MANNITOL; SODIUM; SODIUM CHLORIDE;

ADULT; BRAIN EDEMA; CASE REPORT; EXECISE ASSOCIATED HYPONATREMIA ENCEPHALOPATHY; EXERCISE ASSOCIATED HYPONATREMIA ENCEPHALOPATHY; FEMALE; FLUID INTAKE; FLUID RETENTION; HOSPITAL; HUMAN; HYDRATION; HYPONATREMIA; MALE; METABOLIC ENCEPHALOPATHY; PHYSICAL ACTIVITY; PLASMA VOLUME; PRIORITY JOURNAL; SHORT SURVEY; SODIUM EXCRETION; VASOPRESSIN RELEASE; ARTICLE; DRINKING; EXERCISE; MIDDLE AGED; PATHOPHYSIOLOGY; PHYSIOLOGY; SCHWARTZ BARTTER SYNDROME; THIRST;

ADULT; ARGININE VASOPRESSIN; BRAIN EDEMA; DRINKING; EXERCISE; FEMALE; HUMANS; INAPPROPRIATE ADH SYNDROME; MALE; MIDDLE AGED; SALINE SOLUTION, HYPERTONIC; THIRST;

EID: 49049095776     PISSN: 1050642X     EISSN: None     Source Type: Journal    
DOI: 10.1097/JSM.0b013e3181802c6d     Document Type: Short Survey

References (35)

1. Hew-Butler TD, Ayus JC, Kipps C, et al. Statement of the Second International Exercise-Associated Hyponatremia Consensus Development Conference, New Zealand, 2007. Clin J Sport Med. 2008;18:111-121.
2. Sawka MN, Burke LM, Eichner ER, et al. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 2007;39:377-390.
3. Twerenbold R, Knechtle B, Kakebeeke TH, et al. Effects of different sodium concentrations in replacement fluids during prolonged exercise in women. Br J Sports Med. 2003;37:300-303.
4. Vrijens DM, Rehrer NJ. Sodium-free fluid ingestion decreases plasma sodium during exercise in the heat. J Appl Physiol. 1999;86:1847-1851.
5. Baker LB, Munce TA, Kenney WL. Sex differences in voluntary fluid intake by older adults during exercise. Med Sci Sports Exerc. 2005;37: 789-796.
6. Siegel AJ, Verbalis JG, Clement S, et al. Hyponatremia in marathon runners due to inappropriate arginine vasopressin secretion. Am J Med. 2007;120:461.e11-467.e17.
7. Hew-Butler T, Anley C, Schwartz P, Noakes T. The treatment of symptomatic hyponatremia with hypertonic saline in an Ironman triathlete. Clin J Sport Med. 2007;17:68-69.
8. Frizzell RT, Lang GH, Lowance DC, Lathan SR. Hyponatremia and ultramarathon running. JAMA . 1986;255:772-774.
9. Davis DP, Videen JS, Marino A, et al. Exercise-associated hyponatremia in marathon runners: a two-year experience. J Emerg Med. 2001;21:47-57.
10. Ayus JC, Arieff A, Moritz ML. Hyponatremia in marathon runners. N Engl J Med. 2005;353:427-428.
11. Hew-Butler T, Jordaan E, Stuempfle KJ, et al. Osmotic and non-osmotic regulation of arginine vasopressin during prolonged endurance exercise. J Clin Endocrinol Metab. 2008 Mar 18. [Epub ahead of print].
12. Rowe JW, Shelton RL, Helderman JH, et al. Influence of the emetic reflex on vasopressin release in man. Kidney Int. 1979;16:729-735.
13. Barr SI, Costill DL, Fink WJ. Fluid replacement during prolonged exercise: effects of water, saline, or no fluid. Med Sci Sports Exerc. 1991; 23:811-817.
14. Grant SM, Green HJ, Phillips SM, et al. Fluid and electrolyte hormonal responses to exercise and acute plasma volume expansion. J Appl Physiol. 1996;81:2386-2392.
15. Sims ST, Rehrer NJ, Bell ML, Cotter JD. Preexercise sodium loading aids fluid balance and endurance for women exercising in the heat. J Appl Physiol. 2007;103:534-541.
16. Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med. 1967;42:790-806.
17. Verbalis JG. Disorders of body water homeostasis. Best Pract Res Clin Endocrinol Metab. 2003;17:471-503.
18. Shirreffs SM, Aragon-Vargas LF, Chamorro M, et al. The sweating response of elite professional soccer players to training in the heat. Int J Sports Med. 2005;26:90-95.
19. Patterson MJ, Galloway SD, Nimmo MA. Variations in regional sweat composition in normal human males. Exp Physiol. 2000;85:869-875.
20. Drobin D, Hahn RG. Kinetics of isotonic and hypertonic plasma volume expanders. Anesthesiology. 2002;96:1371-1380.
21. Moritz ML, Ayus JC. Hospital-acquired hyponatremia-why are hypotonic parenteral fluids still being used? Nat Clin Pract Nephrol. 2007;3: 374-382.
22. Irving RA, Noakes TD, Buck R, et al. Evaluation of renal function and fluid homeostasis during recovery from exercise-induced hyponatremia. J Appl Physiol. 1991;70:342-348.
23. Shirreffs SM, Maughan RJ. Volume repletion after exercise-induced volume depletion in humans: replacement of water and sodium losses. Am J Physiol. 1998;274:F868-F875.
24. Casa DJ, Maresh CM, Armstrong LE, et al. Intravenous versus oral rehydration during a brief period: responses to subsequent exercise in the heat. Med Sci Sports Exerc. 2000;32:124-133.
25. Wilkerson JE, Gutin B, Horvath SM. Exercise-induced changes in blood, red cell, and plasma volumes in man. Med Sci Sports. 1977;9: 155-158.
26. Convertino VA, Keil LC, Greenleaf JE. Plasma volume, renin, and vasopressin responses to graded exercise after training. J Appl Physiol. 1983;54:508-514.
27. Backer H, Shopes E, Collins SL. Hyponatremia in recreational hikers in Grand Canyon National Park. Wilderness Med. 1993;4:391-406.
28. Noakes TD, Goodwin N, Rayner BL, et al. Water intoxication: a possible complication during endurance exercise. Med Sci Sports Exerc. 1985;17: 370-375.
29. Zelingher J, Putterman C, Ilan Y, et al. Case series: hyponatremia associated with moderate exercise. Am J Med Sci. 1996;311:86-91.
30. Young M, Sciurba F, Rinaldo J. Delirium and pulmonary edema after completing a marathon. Am Rev Respir Dis. 1987;136:737-739.
31. Davis D, Marino A, Vilke G, et al. Hyponatremia in marathon runners: experience with the inaugural Rock'n Roll Marathon. Ann Emerg Med. 1999;34:S40.
32. Ayus JC, Varon J, Arieff AI. Hyponatremia, cerebral edema, and noncardiogenic pulmonary edema in marathon runners. Ann Intern Med. 2000;132:711-714.
33. Surgenor S, Uphold RE. Acute hyponatremia in ultra-endurance athletes. Am J Emerg Med. 1994;12:441-444.
34. Worthley LI, Thomas PD. Treatment of hyponatraemic seizures with intravenous 29.2% saline. Br Med J (Clin Res Ed). 1986;292:168-170.
35. Hew-Butler T, Sharwood K, Boulter J, et al. Dysnatremia predicts a delayed recovery in collapsed ultramarathon runners. Clin J Sport Med. 2007;17:289-296.