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

Sports Health

Volumn 3, Issue 2, 2011, Pages 145-151

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

^a MAYO CLINIC   (United States)

Author keywords

Endurance sports; Hyponatremia; Marathon; Renal dysfunction; Running

Indexed keywords

EID: 80051730276     PISSN: 19417381     EISSN: 19410921     Source Type: Journal    
DOI: 10.1177/1941738111400561     Document Type: Article

References (53)

1. Adolph EF. Physiological Regulations. Lancaster, PA: Jacques Cattell Press; 1943:502.
2. Almond CS, Shin AY, Fortescue EB, et al. Hyponatremia among runners in the Boston Marathon. N Engl J Med. 2005;352(15):1550-1556.
3. Asadollahi K, Beeching N, Gill G. Hyponatraemia as a risk factor for hospital mortality. QJM. 2006;99(12):877-880.
4. Ayus JC, Varon J, Arieff AI. Hyponatremia, cerebral edema, and noncardiogenic pulmonary edema in marathon runners. Ann Intern Med. 2000;132(9):711-714.
5. Below PR, Mora-Rodríguez R, González-Alonso J, Coyle EF. Fluid and carbohydrate ingestion independently improve performance during 1 h of intense exercise. Med Sci Sports Exerc. 1995;27(2):200-210.
6. Breast Cancer Marathon. Results for the 2008 Breast Cancer Marathon. http://www.breastcancermarathon.com/run/2008-results/
7. Burgess WA, Davis JM, Bartoli WP, Woods JA. Failure of low dose carbohydrate feeding to attenuate glucoregulatory hormone responses and improve endurance performance. Int J Sport Nutr. 1991;1(4):338-352.
8. Casa DJ, Clarkson PM, Roberts WO. American College of Sports Medicine roundtable on hydration and physical activity: consensus statements. Curr Sports Med Rep. 2005;4(3):115-127.
9. Chorley J, Cianca J, Divine J. Risk factors for exercise-associated hyponatremia in non-elite marathon runners. Clin J Sport Med. 2007;17(6):471-477.
10. Coggan AR, Coyle EF. Reversal of fatigue during prolonged exercise by carbohydrate infusion or ingestion. J Appl Physiol. 1987;63(6):2388-2395.
11. Couchoud C, Pozet N, Labeeuw M, Pouteil-Noble C. Screening early renal failure: cut-off values for serum creatinine as an indicator of renal impairment. Kidney Int. 1999;55(5):1878-1884.
12. Coyle EF, Coggan AR, Hemmert MK, Ivy JL. Muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate. J Appl Physiol. 1986;61(1):165-172.
13. Coyle EF, Montain SJ. Carbohydrate and fluid ingestion during exercise: are there trade-offs? Med Sci Sports Exerc. 1992;24(6):671-678.
14. Davis DP, Videen JS, Marino A, et al. Exercise-associated hyponatremia in marathon runners: a two-year experience. J Emerg Med. 2001;21(1):47-57.
15. Davis JM, Welsh RS, Alerson NA. Effects of carbohydrate and chromium ingestion during intermittent high-intensity exercise to fatigue. Int J Sport Nutr Exerc Metab. 2000;10(4):476-485.
16. Davis JM, Welsh RS, De Volve KL, Alderson NA. Effects of branched-chain amino acids and carbohydrate on fatigue during intermittent, high-intensity running. Int J Sports Med. 1999;20(5):309-314.
17. Felig P, Cherif A, Minagawa A, Wahren J. Hypoglycemia during prolonged exercise in normal men. N Engl J Med. 1982;306(15):895-900.
18. Frizzell RT, Lang GH, Lowance DC, Lathan SR. Hyponatremia and ultramarathon running. JAMA. 1986;255(6):772-774.
19. 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(1):68-69.
20. Hew-Butler T, 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(2):111-121.
21. Hew-Butler T, Jordaan E, Stuempfle KJ, et al. Osmotic and nonosmotic regulation of arginine vasopressin during prolonged endurance exercise. J Clin Endocrinol Metab. 2008;93(6):2072-2078.
22. Hew TD, Hew TD, Chorley JN, Cianca JC, Divine JG. The incidence, risk factors, and clinical manifestations of hyponatremia in marathon runners. Clin J Sport Med. 2003;13(1):41-47.
23. M. Another close call with hyponatremia. http://www.restonrunners.org/special/hyponatremia/KCGuevera-CloseCall.php.
24. Hsieh M, Roth R, Davis DL, Larrabee H, Callaway CW. Hyponatremia in runners requiring on-site medical treatment at a single marathon. Med Sci Sports Exerc. 2002;34(2):185-189.
25. Irving RA, Noakes TD, Buck R. Evaluation of renal function and fluid homeostasis during recovery from exercise-induced hyponatremia. J Appl Physiol. 1991;70(1):342-348.
26. Kang J, Robertson RJ, Goss FL, et al. Effect of carbohydrate substrate availability on ratings of perceived exertion during prolonged exercise of moderate intensity. Percept Mot Skills. 1996;82(2):495-506.
27. Maughan RJ, Leiper JB, Shirreffs SM. Restoration of fluid balance after exercise-induced dehydration: effects of food and fluid intake. Eur J Appl Physiol Occup Physiol. 1996;73(3-4):317-325.
28. Mettler S, Rusch C, Frey WO, Bestmann L, Wenk C, Colombani PC. Hyponatremia among runners in the Zurich Marathon. Clin J Sport Med. 2008;18(4):344-349.
29. Nicholas CW, Williams C, Lakomy HK, Phillips G, Nowitz A. Influence of ingesting a carbohydrate-electrolyte solution on endurance capacity during intermittent, high-intensity shuttle running. J Sports Sci. 1995;13(4):283-290.
30. Noakes TD. Overconsumption of fluids by athletes. BMJ. 2003;327(7407):113-114.
31. Noakes TD, Carter JW. Biochemical parameters in athletes before and after having run 160 kilometres. S Afr Med J. 1976;50(40):1562-1566.
32. Noakes TD, Norman RJ, Buck RH, Godlonton J, Stevenson K, Pittaway D. The incidence of hyponatremia during prolonged ultraendurance exercise. Med Sci Sports Exerc. 1990;22(2):165-170.
33. Noakes TD, Sharwood K, Speedy D, et al. Three independent biological mechanisms cause exercise-associated hyponatremia: evidence from 2,135 weighed competitive athletic performances. Proc Natl Acad Sci U S A. 2005;102(51):18550-18555.
34. Page AJ, Reid SA, Speedy DB, Mulligan GP, Thompson J. Exercise-associated hyponatremia, renal function, and nonsteroidal antiinflammatory drug use in an ultraendurance mountain run. Clin J Sport Med. 2007;17(1):43-48.
35. Ray ML, Bryan MW, Ruden TM, Baier SM, Sharp RL, King DS. Effect of sodium in a rehydration beverage when consumed as a fluid or meal. J Appl Physiol. 1998;85(4):1329-1336.
36. Reid SA, Speedy DB, Thompson JM, et al. Study of hematological and biochemical parameters in runners completing a standard marathon. Clin J Sport Med. 2004;14(6):344-353.
37. Roberts WO. A 12-year profile of medical injury and illness for the Twin Cities Marathon. Med Sci Sports Exerc. 2000;32(9):1549-1555.
38. Running USA. Track and field running information center. http://www.runningusa.org.Accessed January 7, 2011.
39. Shapiro SA, Ejaz AA, Osborne MD, Taylor WC. Moderate exercise-induced hyponatremia. Clin J Sport Med. 2006;16(1):72-73.
40. Sharwood K, Collins M, Goedecke J, Wilson G, Noakes T. Weight changes, sodium levels, and performance in the South African Ironman Triathlon. Clin J Sport Med. 2002;12(6):391-399.
41. Speedy DB, Noakes TD, Rogers IR, et al. Hyponatremia in ultradistance triathletes. Med Sci Sports Exerc. 1999;31(6):809-815.
42. Speedy DB, Noakes TD, Schneider C. Exercise-associated hyponatremia: a review. Emerg Med. 2001;13(1):17-27.
43. Speedy DB, Rogers IR, Noakes TD, et al. Diagnosis and prevention of hyponatremia at an ultradistance triathlon. Clin J Sport Med. 2000;10(1):52-58.
44. Steinberg D. Running the risk of too much water: hyponatremia can sometimes lead to death for marathoners. Washington Post. October 24, 2003:A1.
45. Thadhani R, Pascual M, Bonventre JV. Acute renal failure. N Engl J Med. 1996;334(22):1448-1460.
46. Utter A, Kang J, Nieman DC, et al. Effect of carbohydrate substrate availability on ratings of perceived exertion during prolonged running. Int J Sport Nutr. 1997;7(4):274-285.
47. van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41(8):469-480.
48. W. The history of the marathon. http://www.exercisetherighttoread.org/historyofmarathon.pdf. Accessed January 7, 2011.
49. Welsh RS, Davis JM, Burke JR, Williams HG. Carbohydrates and physical/ mental performance during intermittent exercise to fatigue. Med Sci Sports Exerc. 2002;34(4):723-731.
50. Wharam PC, Speedy DB, Noakes TD, Thompson JM, Reid SA, Holtzhausen LM. NSAID use increases the risk of developing hyponatremia during an Ironman triathlon. Med Sci Sports Exerc. 2006;38(4):618-622.
51. Whiting PH, Maughan RJ, Miller JD. Dehydration and serum biochemical changes in marathon runners. Eur J Appl Physiol Occup Physiol. 1984;52(2):183-187.
52. Yip R, Johnson C, Dallman PR. Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. Am J Clin Nutr. 1984;39(3):427-436.
53. Young M, Sciurba F, Rinaldo J. Delirium and pulmonary edema after completing a marathon. Am Rev Respir Dis. 1987;136(3):737-739.