TY - JOUR
T1 - Incidence and Prevalence of Acute Kidney Injury during Multistage Ultramarathons
AU - Lipman, Grant S.
AU - Krabak, Brian J.
AU - Rundell, Sean D.
AU - Shea, Katherine M.
AU - Badowski, Natalie
AU - Little, Colin
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Objective: Determine prevalence, incidence, and risk factors of acute kidney injury (AKI) during multistage ultramarathons. Design: Prospective observational cohort study. Setting: Jordanian Desert 2012; Atacama Desert, Chile 2012 and 2013; and Gobi Desert 2013 RacingThePlanet 250 km, 6-stage, ultramarathons. Participants: One hundred twenty-eight participants (384 measurements) from the Jordan (25, 19.5%), Gobi (35, 27.3%), 2012 Atacama (24, 18.8%), and 2013 Atacama (44, 34.4%) races. Interventions: Blood samples and weights were gathered and analyzed immediately after stage 1 (40 km), 3 (120 km), and 5 (225 km). Main Outcome Measures: Changes in serum creatinine (Cr), cumulative incidence, and prevalence of AKI were calculated for each stage with "risk of injury" defined as 1.5 × baseline Cr and "injury" defined as 2 × Cr. Results: Cumulative incidence of AKI was 41.4%. Stage 1 had 56 (43.8%) with risk of AKI and 24 (18.8%) with injury; in stage 3, 61 (47.7%) were at risk, 41 (32%) had injury; in stage 5, 62 (48.4%) runners were at risk and 36 (28.1%) had injury. Acute kidney injury was significantly associated with females [odds ratio (OR), 4.64; 95% confidence interval (CI), 2.07-10.37; P < 0.001], lower pack weight (OR, 0.71; 95% CI, 0.56-0.91; P < 0.007), and percentage weight loss (OR, 0.87; 95% CI, 0.78-0.97; P < 0.015). Lowest quintile of finishers was less likely to develop AKI (OR, 0.18; 95% CI, 0.04-0.78; P < 0.022). Conclusions: Prevalence of AKI was 63%-78% during multistage ultramarathons. Female sex, lower pack weight, and greater weight loss were associated with renal impairment.
AB - Objective: Determine prevalence, incidence, and risk factors of acute kidney injury (AKI) during multistage ultramarathons. Design: Prospective observational cohort study. Setting: Jordanian Desert 2012; Atacama Desert, Chile 2012 and 2013; and Gobi Desert 2013 RacingThePlanet 250 km, 6-stage, ultramarathons. Participants: One hundred twenty-eight participants (384 measurements) from the Jordan (25, 19.5%), Gobi (35, 27.3%), 2012 Atacama (24, 18.8%), and 2013 Atacama (44, 34.4%) races. Interventions: Blood samples and weights were gathered and analyzed immediately after stage 1 (40 km), 3 (120 km), and 5 (225 km). Main Outcome Measures: Changes in serum creatinine (Cr), cumulative incidence, and prevalence of AKI were calculated for each stage with "risk of injury" defined as 1.5 × baseline Cr and "injury" defined as 2 × Cr. Results: Cumulative incidence of AKI was 41.4%. Stage 1 had 56 (43.8%) with risk of AKI and 24 (18.8%) with injury; in stage 3, 61 (47.7%) were at risk, 41 (32%) had injury; in stage 5, 62 (48.4%) runners were at risk and 36 (28.1%) had injury. Acute kidney injury was significantly associated with females [odds ratio (OR), 4.64; 95% confidence interval (CI), 2.07-10.37; P < 0.001], lower pack weight (OR, 0.71; 95% CI, 0.56-0.91; P < 0.007), and percentage weight loss (OR, 0.87; 95% CI, 0.78-0.97; P < 0.015). Lowest quintile of finishers was less likely to develop AKI (OR, 0.18; 95% CI, 0.04-0.78; P < 0.022). Conclusions: Prevalence of AKI was 63%-78% during multistage ultramarathons. Female sex, lower pack weight, and greater weight loss were associated with renal impairment.
KW - acute kidney injury
KW - incidence
KW - multistage
KW - prevalence
KW - risk factors
KW - ultramarathon
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U2 - 10.1097/JSM.0000000000000253
DO - 10.1097/JSM.0000000000000253
M3 - Article
C2 - 26513390
AN - SCOPUS:84945529903
SN - 1050-642X
VL - 26
SP - 314
EP - 319
JO - Clinical Journal of Sport Medicine
JF - Clinical Journal of Sport Medicine
IS - 4
ER -