Rhabdomyolysis and exercise-associated hyponatremia in ultra-bikers and ultra-runners

• Published in: Journal of the International Society of Sports Nutrition 2015-06, Vol.12, p.29-29
• Main Authors: Chlíbková, Daniela, Knechtle, Beat, Rosemann, Thomas, Tomášková, Ivana, Novotný, Jan, Žákovská, Alena, Uher, Tomáš
• Format: Article
• Language: English
• Subjects: Adult; Athletes; Bicycling; Body Mass Index; Comorbidity; Creatine; Creatine kinase; Creatine Kinase - blood; Creatinine - urine; Cyclists; Development and progression; Exercise; Female; Health aspects; Humans; Hyponatremia; Hyponatremia - blood; Hyponatremia - urine; Male; Middle Aged; Physiological aspects; Potassium - blood; Rhabdomyolysis; Rhabdomyolysis - blood; Rhabdomyolysis - urine; Runners (Sports); Running; Sodium - blood
• ISSN: 1550-2783; 1550-2783
• DOI: 10.1186/s12970-015-0091-x

Exercise-associated hyponatremia (EAH), rhabdomyolysis and renal failure appear to be a unique problem in ultra-endurance racers. We investigated the combined occurrence of EAH and rhabdomyolysis in seven different ultra-endurance races and disciplines (i.e. multi-stage mountain biking, 24-h mountain biking, 24-h ultra-running and 100-km ultra-running). Two (15.4%) ultra-runners (man and woman) from hyponatremic ultra-athletes (n = 13) and four (4%) ultra-runners (four men) from the normonatremic group (n = 100) showed rhabdomyolysis following elevated blood creatine kinase (CK) levels > 10,000 U/L without the development of renal failure and the necessity of a medical treatment. Post-race creatine kinase, plasma and urine creatinine significantly increased, while plasma [Na(+)] and creatine clearance decreased in hyponatremic and normonatremic athletes, respectively. The percentage increase of CK was higher in the hyponatremic compared to the normonatremic group (P