Acute Variation of Estimated Glomerular Filtration Rate Following a Half-Marathon Run

Abstract

The accurate estimation of glomerular filtration rate (GFR) is pivotal in sports medicine. However, there is controversial information on the acute influence of physical exercise on kidney function in healthy athletes. The estimated GFR (EGFR) was assessed by the recommended Modification of Diet in Renal Disease (MDRD) equation before a 21-km half-marathon, at the end, and 3, 6, 24 hrs thereafter on 17 trained, middle-aged males. Results were corrected for plasma volume changes. The mean EGFR at the baseline was 76 mL/min/1.73 m²; it decreased at the end of the run (62 mL/min/1.73 m²) and for the following 3 hrs (68 mL/min/1.73 m²) and 6 hrs (70 mL/min/1.73 m²), though statistical significance was only achieved immediately after the run (mean decrease 16 %, p < 0.01). The frequency of athletes with EGFR below the normal threshold was higher than the baseline immediately after the race and for the following 6 hrs. Twenty-four hours after the run, the EGFR had returned to values similar and nonsignificantly different from those recorded at the baseline. These results attest that medium to high strains of running in healthy, middle-aged, trained individuals do not cause renal damage, but a limited and temporary decline in renal function.

Key words

creatinine - GFR - glomerular function rate - EGFR - sports

References

• 1 Banfi G, Del Fabbro M, Lippi G. Relation between serum creatinine and body mass index in elite athletes of different sport disciplines.  Br J Sports Med. 2006;  40 675-678
• 2 Banfi G, Del Fabbro M. Serum creatinine values in elite athletes competing in 8 different sports: comparison with sedentary people.  Clin Chem. 2006;  52 330-331
• 3 Blair S N, LaMonte M J, Nichaman M Z. The evolution of physical activity recommendations: how much is enough?.  Am J Clin Nutr. 2004;  79 913S-920S
• 4 Capelli C, Schena F, Zamparo P, Monte A D, Faina M, di Prampero P E. Energetics of best performances in track cycling.  Med Sci Sports Exerc. 1998;  30 614-624
• 5 Dill D B, Costill D L. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration.  J Appl Physiol. 1974;  37 247-248
• 6 Finkelstein J, Joshi A, Hise M K. Association of physical activity and renal function in subjects with and without metabolic syndrome: a review of the Third National Health and Nutrition Examination Survey (NHANES III).  Am J Kidney Dis. 2006;  48 372-382
• 7 Haskell W L, Lee I M, Pate R R, Powell K E, Blair S N, Franklin B A, Macera C A, Heath G W, Thompson P D, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association.  Med Sci Sports Exerc. 2007;  39 1423-1434
• 8 Irving R A, Noakes T D, Burger S C, Myburgh K H, Querido D, van Zyl Smit R. Plasma volume and renal function during and after ultramarathon running.  Med Sci Sports Exerc. 1990;  22 581-587
• 9 Künstlinger U, Ludwig H G, Stegemann J. Metabolic changes during volleyball matches.  Int J Sports Med. 1987;  8 315-322
• 10 Lamb E J, Tomson C R, Roderick P J. Clinical Sciences Reviews Committee of the Association for Clinical Biochemistry . Estimating kidney function in adults using formulae.  Ann Clin Biochem. 2005;  42 321-345
• 11 Levey A S. Measurement of renal function in chronic renal disease.  Kidney Int. 1990;  338 167-184
• 12 Levey A S, Coresh J, Balk E, Kausz A T, Levin A, Steffes M W, Hogg R J, Perrone R D, Lau J, Eknoyan G. National Kidney Foundation. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification.  Ann Intern Med. 2004;  139 137-147
• 13 Levey A S, Coresh J, Greene T, Marsh J, Stevens L A, Kusek J W, Van Lente F. Chronic Kidney Disease Epidemiology Collaboration. Expressing the modification of diet in renal disease study equation for estimating glomerular filtration rate with standardized serum creatinine values.  Clin Chem. 2007;  53 766-772
• 14 Lippi G, Brocco G, Franchini M, Schena F, Guidi G. Comparison of serum creatinine, uric acid, albumin and glucose in male professional endurance athletes compared with healthy controls.  Clin Chem Lab Med. 2004;  42 644-647
• 15 Lippi G, Salvagno G L, Guidi G C. Other advantages to aerobic exercise.  CMAJ. 2005;  173 1066
• 16 Lippi G, Schena F, Salvagno G L, Montagnana M, Ballestrieri F, Guidi G C. Comparison of the lipid profile and lipoprotein(a) between sedentary and highly trained subjects.  Clin Chem Lab Med. 2006;  44 322-326
• 17 Myers G L, Miller W G, Coresh J, Fleming J, Greenberg N, Greene T, Hostetter T, Levey A S, Panteghini M, Welch M, Eckfeldt J H. National Kidney Disease Education Program Laboratory Working Group. Recommendations for improving serum creatinine measurement: a report from the Laboratory Working Group of the National Kidney Disease Education Program.  Clin Chem. 2006;  52 5-18
• 18 Neumayr G, Pfister R, Hoertnagl H, Mitterbauer G, Getzner W, Ulmer H, Gaenzer H, Joannidis M. The effect of marathon cycling on renal function.  Int J Sports Med. 2003;  24 131-137
• 19 Neumayr G, Pfister R, Hoertnagl H, Mitterbauer G, Prokop W, Joannidis M. Renal function and plasma volume following ultramarathon cycling.  Int J Sports Med. 2005;  26 2-8
• 20 Page A J, Reid S A, Speedy D B, Mulligan G P, Thompson J. Exercise-associated hyponatremia, renal function, and nonsteroidal antiinflammatory drug use in an ultraendurance mountain run.  Clin J Sport Med. 2007;  17 43-48
• 21 Poortmans J R, Jourdain M, Heyters C, Reardon F D. Postexercise proteinuria in rowers.  Can J Sport Sci. 1990;  15 126-130
• 22 Thomas L, Huber A R. Renal function – estimation of glomerular filtration rate.  Clin Chem Lab Med. 2006;  44 1295-1302
• 23 Touchberry C D, Ernsting M, Haff G, Kilgore J L. Training alterations in elite cyclists may cause transient changes in glomerular filtration rate.  J Sports Sci Med. 2004;  3 28-36