Changes in renal markers and acute kidney injury after marathon running
Changes in renal markers and acute kidney injury after marathon running
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DOI：
10.1111/j.1440-1797.2010.01354.x
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发表时间：
2011-02-01
期刊：
影响因子：
2.5
通讯作者：
Trivax, Justin E.
中科院分区：
文献类型：
--
作者：
McCullough, Peter A.;Chinnaiyan, Kavitha M.;Trivax, Justin E.
背景：马拉松跑步对肾功能的影响以前没有描述过。方法：从425名马拉松跑步者中随机选择13名女性和12名男性，并在赛前4周（基线）、赛后即刻（峰值）和赛后24小时（恢复）进行心血管磁共振成像（MRI）和血液/尿液生物标志物检查。结果：参与者年龄为38.7 ± 9.0岁，在256.2 ± 43.5分钟内完成了马拉松。共有10/25（40.0%）人符合急性肾损伤网络基于血清肌酐升高的急性肾损伤（阿基）定义。血清肌酐和半胱氨酸蛋白酶抑制剂C从基线至峰值的平均升高平行且相似，并在恢复期恢复至正常。尿中性粒细胞明胶酶相关脂质运载蛋白从8.2 +/- 4.0上升至47.0 +/- 28.6，然后恢复至10.6 +/- 7.2 ng/mL，P < 0.0001。同样，平均尿肾损伤分子-1水平为2.6 +/- 1.6、3.5 +/- 1.6和2.7 +/- 1.6 ng/mL（P = 0.001）。平均和最小前和后IVC（下腔静脉）直径MRI分别为24.9，18.8和25.3，17.5毫米，表明跑步者在第一次赛后measurement.Conclusion：约40%的马拉松选手的经验，血清肌酐的短暂上升，符合标准的阿基与平行的半胱氨酸蛋白酶抑制剂C的升高，和支持性升高中性粒细胞明胶酶相关的脂质运载蛋白和肾损伤分子-1的尿液。所有生物标志物升高均在24小时内消退。这些数据表明，在马拉松跑步的压力下，发生了肾滤过功能短暂和轻微变化的阿基。阿基重复发作对长跑的影响尚不清楚。
Background:The impact of marathon running on kidney function has not been previously described.Methods:From 425 marathon runners, 13 women and 12 men were randomly selected and cardiovascular magnetic resonance imaging (MRI) and blood/urine biomarkers were performed 4 weeks before (baseline), immediately after (peak), and 24 h after the race (recovery).Results:Participants were 38.7 +/- 9.0 years old and completed the marathon in 256.2 +/- 43.5 min. A total of 10/25 (40.0%) met the Acute Kidney Injury Network definition of acute kidney injury (AKI) based on a rise in serum creatinine. There were parallel and similar mean rises in serum creatinine and cystatin C from baseline, to peak, and return to normal in recovery. Urine neutrophil gelatinase-associated lipocalin rose from 8.2 +/- 4.0 to 47.0 +/- 28.6 and returned to 10.6 +/- 7.2 ng/mL, P < 0.0001. Likewise, the mean urinary kidney injury molecule-1 levels were 2.6 +/- 1.6, 3.5 +/- 1.6 and 2.7 +/- 1.6 ng/mL (P = 0.001). The mean and minimum pre- and post-IVC (inferior vena cava) diameters by MRI were 24.9, 18.8 and 25.3, 17.5 mm, respectively, suggesting that runners were not volume depleted at the first post-race measurement.Conclusion:Approximately 40% of marathon runners experience a transient rise in serum creatinine that meets criteria of AKI with a parallel elevation of cystatin C, and supportive elevations of neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in the urine. All biomarker elevations resolved by 24 h. These data suggest that AKI with a transient and minor change in renal filtration function occurs with the stress of marathon running. The impact of repetitive episodes of AKI with long-distance running is unknown.