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He P, Deng Y, Dong S, Li H, Liu C, Ma Y, Tang C, Zhang M. Association of different domains of physical activity with diabetic kidney disease: a population-based study. Front Endocrinol (Lausanne) 2024; 15:1364028. [PMID: 38863925 PMCID: PMC11165133 DOI: 10.3389/fendo.2024.1364028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/13/2024] [Indexed: 06/13/2024] Open
Abstract
Background The aim of this cross-sectional study was to elucidate the associations between various domains of physical activity, such as occupation-related (OPA), transportation-related (TPA), leisure-time (LTPA) and overall physical activity (PA), and diabetic kidney disease. Methods Our study encompassed 2,633 participants, drawn from the cross-sectional surveys of the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, and employed survey-weighted logistic regression, generalized linear regression, and restricted cubic spline (RCS) analyses to ascertain the relationship between different domains of physical activity and diabetic kidney disease. Results After controlling for all confounders, multivariate logistic regression analyses revealed a lack of correlation between the various domains of physical activity and the prevalence of diabetic kidney disease. Multiple generalized linear regression analyses showed that durations of PA (β = 0.05, 95% CI, 0.01-0.09, P = 0.012) and TPA (β = 0.32, 95% CI, 0.10-0.55, P = 0.006) were positively associated with eGFR levels; and LTPA durations were inversely associated with UACR levels (β = -5.97, 95% CI, -10.50 - -1.44, P = 0.011). The RCS curves demonstrated a nonlinear relationship between PA, OPA, and eGFR, as well as a nonlinear correlation between PA and ACR. Subgroup and sensitivity analyses largely aligned with the outcomes of the multivariate generalized linear regression, underscoring the robustness of our findings. Conclusion Our population-based study explored the association between different domains of physical activity and diabetic kidney disease. Contrary to our expectations, we found no significant association between the duration of physical activity across all domains and the prevalence of diabetic nephropathy. Nonetheless, renal function markers, including eGFR and UACR, exhibited significant correlations with the duration of total physical activity (TPA) and leisure-time physical activity (LTPA), respectively, among diabetic patients. Interestingly, our findings suggest that diabetic patients engage in physical activity to preserve renal function, ensuring moderate exercise durations not exceeding 35 hours per week.
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Affiliation(s)
- Pengfei He
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanyuan Deng
- Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Shaoning Dong
- Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Hongdian Li
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Cong Liu
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Ma
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Cheng Tang
- Department of Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mianzhi Zhang
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
- Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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Juett LA, Drury JE, Greensmith TB, Thompson AP, Funnell MP, James LJ, Mears SA. Hypohydration induced by prolonged cycling in the heat increases biomarkers of renal injury in males. Eur J Appl Physiol 2024; 124:1085-1096. [PMID: 37848571 PMCID: PMC10954877 DOI: 10.1007/s00421-023-05328-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/16/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE Recent studies have shown that hypohydration can increase renal injury. However, the contribution of hypohydration to the extent of renal injury is often confounded by exercise induced muscle damage. Therefore, the aim of the present study was to investigate the effect of manipulating hydration status during moderate-intensity cycling in the heat on biomarkers of renal injury. METHODS Following familiarisation, fourteen active males (age: 21 [20-22] y; BMI: 22.1 ± 1.9 kg/m2; V ˙ O2peak: 55 ± 9 mL/kg/min) completed two experimental trials, in a randomised cross-over design. Experimental trials consisted of up to 120 min of intermittent cycling (~ 50% Wpeak) in the heat (~ 35 °C, ~ 50% relative humidity). During exercise, subjects consumed either a water volume equal to 100% body mass losses (EU) or minimal water (HYP; 75-100 mL) to induce ~ 3% body mass loss. Blood and urine samples were collected at baseline, 30 min post-exercise and 24 h post-baseline, with an additional urine sample collected immediately post-exercise. RESULTS Thirty minutes post-exercise, body mass and plasma volume were lower in HYP than EU (P < 0.001), whereas serum and urine osmolality (P < 0.001), osmolality-corrected urinary kidney injury molecule-1 concentrations (HYP: 2.74 [1.87-5.44] ng/mOsm, EU: 1.15 [0.84-2.37] ng/mOsm; P = 0.024), and percentage change in osmolality-corrected urinary neutrophil gelatinase-associated lipocalin concentrations (HYP: 61 [17-141] %, EU: 7.1 [- 4 to 24] %; P = 0.033) were greater in HYP than EU. CONCLUSION Hypohydration produced by cycling in the heat increased renal tubular injury, compared to maintaining euhydration with water ingestion.
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Affiliation(s)
- Loris A Juett
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
- Loughborough College, Loughborough, LE11 3BT, UK
| | - Jack E Drury
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Thomas B Greensmith
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Alfie P Thompson
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Mark P Funnell
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Stephen A Mears
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.
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Kawakami S, Yasuno T, Kawakami S, Ito A, Fujimi K, Matsuda T, Nakashima S, Masutani K, Uehara Y, Higaki Y, Michishita R. Effects of high-intensity intermittent exercise versus moderate-intensity continuous exercise on renal hemodynamics assessed by ultrasound echo. Physiol Rep 2024; 12:e15925. [PMID: 38262710 PMCID: PMC10805622 DOI: 10.14814/phy2.15925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024] Open
Abstract
High-intensity intermittent exercise (HIIE) has become attractive for presenting a variety of exercise conditions. However, the effects of HIIE on renal function and hemodynamics remain unclear. This study aimed to compare the effects of HIIE and moderate-intensity continuous exercise (MICE) on renal hemodynamics, renal function, and kidney injury biomarkers. Ten adult males participated in this study. We allowed the participants to perform HIIE or MICE to consider the impact of exercise on renal hemodynamics under both conditions. Renal hemodynamic assessment and blood sampling were conducted before the exercise (pre) and immediately (post 0), 30 min (post 30), and 60 min (post 60) after the exercise. Urine sampling was conducted in the pre, post 0, and post 60 phases. There was no condition-by-time interaction (p = 0.614), condition (p = 0.422), or time effect (p = 0.114) regarding renal blood flow. Creatinine-corrected urinary neutrophil gelatinase-associated lipocalin concentrations increased at post 60 (p = 0.017), but none exceeded the cut-off values for defining kidney injury. Moreover, there were no significant changes in other kidney injury biomarkers at any point. These findings suggest that high-intensity exercise can be performed without decreased RBF or increased kidney injury risk when conducted intermittently for short periods.
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Affiliation(s)
- Shotaro Kawakami
- Graduate School of Sports and Health ScienceFukuoka UniversityFukuokaJapan
- Faculty of Sports and Health ScienceFukuoka UniversityFukuokaJapan
- The Fukuoka University Institute for Physical ActivityFukuokaJapan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Department of Internal MedicineFukuoka University School of MedicineFukuokaJapan
| | - Saki Kawakami
- The Fukuoka University Institute for Physical ActivityFukuokaJapan
| | - Ai Ito
- The Fukuoka University Institute for Physical ActivityFukuokaJapan
| | - Kanta Fujimi
- Department of RehabilitationFukuoka University HospitalFukuokaJapan
| | - Takuro Matsuda
- Department of RehabilitationFukuoka University HospitalFukuokaJapan
| | - Shihoko Nakashima
- Faculty of Sports and Health ScienceFukuoka UniversityFukuokaJapan
- The Fukuoka University Institute for Physical ActivityFukuokaJapan
| | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal MedicineFukuoka University School of MedicineFukuokaJapan
| | - Yoshinari Uehara
- Faculty of Sports and Health ScienceFukuoka UniversityFukuokaJapan
- The Fukuoka University Institute for Physical ActivityFukuokaJapan
| | - Yasuki Higaki
- Faculty of Sports and Health ScienceFukuoka UniversityFukuokaJapan
- The Fukuoka University Institute for Physical ActivityFukuokaJapan
| | - Ryoma Michishita
- Faculty of Sports and Health ScienceFukuoka UniversityFukuokaJapan
- The Fukuoka University Institute for Physical ActivityFukuokaJapan
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Forsse JS, Richardson KA, Torres R, Lowry C, Taylor JK, Beeson CL, Ward J, Dhillon A, Niceler B, Ismaeel A, Koutakis P. Exploring an Unknown Corner of a Well-Known Topic: HIIE Influence on Renal Health and Filtration in Healthy Individuals Free of Cardiometabolic Diseases. Sports (Basel) 2023; 11:210. [PMID: 37999427 PMCID: PMC10675315 DOI: 10.3390/sports11110210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/18/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
Aerobic exercise, specifically high-intensity interval exercise (HIIE), and its effects on renal health and filtration (RHF) are not well understood. Several studies support incorporating contemporary biomarkers serum cystatin C (CyC) and urine epidermal growth factor (uEGF) to combat the volatility of serum creatinine (sCr). Using these biomarkers, we examined the acute influences HIIE has on RHF to determine if there is a ceiling effect in healthy populations. The purpose was to determine the influence of an acute bout of HIIE on RHF. Thirty-six participants (n = 22 males; n = 14 females; age 37.6 ± 12.4 years.; BF% 19.2 ± 7.1%; VO2max 41.8 + 7.4 mL/kg/min) completed 30 min of HIIE on a treadmill (80% and 40% of VO2reserve in 3:2 min ratio). Blood and urine samples were obtained under standardized conditions before, 1 h, and 24 h post-exercise. CyC, sCR, uEGF, urine creatinine (uCr), uCr/uEGF ratio, and multiple estimates of glomerular filtration rate (eGFR) Modification of Diet in Renal Disease (MDRD) and CKD-EPI equations were used. The analysis employed paired sample t-tests and repeated measures ANOVAs. CyC, uEGF, uCr, and uCr/uEGF ratio concentrations were not altered between timepoints. sCr increased 1 h post-exercise (p > 0.002) but not at 24 h post-exercise. eGFR decreased in the MDRD and CKD-EPI equations at 1 h (p > 0.012) with no changes at 24 h post-exercise. CyC and sCr/CyC demonstrated no significant changes. CyC and uEGF are not altered by acute HIIE. The results demonstrate a potential ceiling effect in contemporary and traditional biomarkers of RHF, indicating improvements in RHF may be isolated to populations with reduced kidney function.
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Affiliation(s)
- Jeffrey S. Forsse
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
| | - Kathleen A. Richardson
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
| | - Ricardo Torres
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
| | - Catherine Lowry
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80011, USA
| | - James Kyle Taylor
- Medical & Clinical Laboratory Sciences, Auburn University—Montgomery, Montgomery, AL 36124, USA;
| | - Cassidy L. Beeson
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
| | - Jacob Ward
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
- Southern Illinois University Medical School, Lindegren Hall, 600 Agriculture Dr #132, Carbondale, IL 62901, USA
| | - Anurag Dhillon
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
- Health Science Center, San Antonio Joe R and Teresa Lozano Long School of Medicine, The University of Texas, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Brock Niceler
- Integrated Laboratory of Exercise, Nutrition, and Renal Vascular Research, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX 76706, USA; (K.A.R.); (R.T.); (C.L.); (C.L.B.); (J.W.); (A.D.); (B.N.)
- Waco Family Medicine, Waco, TX 76707, USA
| | - Ahmed Ismaeel
- Department of Physiology, University of Kentucky, 780 Rose Street, MS508, Lexington, KY 40536, USA;
- Clinical Muscle Biology Lab, Baylor University, Waco, TX 76706, USA;
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Costanti-Nascimento AC, Brelaz-Abreu L, Bragança-Jardim E, Pereira WDO, Camara NOS, Amano MT. Physical exercise as a friend not a foe in acute kidney diseases through immune system modulation. Front Immunol 2023; 14:1212163. [PMID: 37928533 PMCID: PMC10623152 DOI: 10.3389/fimmu.2023.1212163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023] Open
Abstract
Regular and moderate exercise is being used for therapeutic purposes in treating several diseases, including cancer, cardiovascular diseases, arthritis, and even chronic kidney diseases (CKDs). Conversely, extenuating physical exercise has long been pointed out as one of the sources of acute kidney injury (AKI) due to its severe impact on the body's physiology. AKI development is associated with increased tubular necrosis, which initiates a cascade of inflammatory responses. The latter involves cytokine production, immune cell (macrophages, lymphocytes, and neutrophils, among others) activation, and increased oxidative stress. AKI can induce prolonged fibrosis stimulation, leading to CKD development. The need for therapeutic alternative treatments for AKI is still a relevant issue. In this context arises the question as to whether moderate, not extenuating, exercise could, on some level, prevent AKI. Several studies have shown that moderate exercise can help reduce tissue damage and increase the functional recovery of the kidneys after an acute injury. In particular, the immune system can be modulated by exercise, leading to a better recovery from different pathologies. In this review, we aimed to explore the role of exercise not as a trigger of AKI, but as a modulator of the inflammatory/immune system in the prevention or recovery from AKI in different scenarios. In AKI induced by ischemia and reperfusion, sepsis, diabetes, antibiotics, or chemotherapy, regular and/or moderate exercise could modulate the immune system toward a more regulatory immune response, presenting, in general, an anti-inflammatory profile. Exercise was shown to diminish oxidative stress, inflammatory markers (caspase-3, lactate dehydrogenase, and nitric oxide), inflammatory cytokines (interleukin (IL)-1b, IL-6, IL-8, and tumor necrosis factor-α (TNF-α)), modulate lymphocytes to an immune suppressive phenotype, and decrease tumor necrosis factor-β (TGF-β), a cytokine associated with fibrosis development. Thus, it creates an AKI recovery environment with less tissue damage, hypoxia, apoptosis, or fibrosis. In conclusion, the practice of regular moderate physical exercise has an impact on the immune system, favoring a regulatory and anti-inflammatory profile that prevents the occurrence of AKI and/or assists in the recovery from AKI. Moderate exercise should be considered for patients with AKI as a complementary therapy.
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Affiliation(s)
- Ana Carolina Costanti-Nascimento
- Instituto Sírio-Libanês de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, Brazil
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Leonilia Brelaz-Abreu
- Instituto Sírio-Libanês de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, Brazil
| | | | - Welbert de Oliveira Pereira
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Niels Olsen Saraiva Camara
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Mariane Tami Amano
- Instituto Sírio-Libanês de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, Brazil
- Departamento de Oncologia Clínica e Experimental, Escola Paulista de Medicina (UNIFESP), São Paulo, Brazil
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Suarez JJ, Elon L, Rangel-Rodriguez A, Xiuhtecutli N, Houser MC, Hertzberg V, McCauley L, Sands JM, Chicas RC. A Pilot Study Examining the Use of Ultrasound to Measure Intravascular Volume Status in Agricultural Workers in a Field-Based Research Setting. J Occup Environ Med 2023; 65:685-688. [PMID: 37167934 PMCID: PMC10524425 DOI: 10.1097/jom.0000000000002880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The aim of this pilot study was to explore if internal jugular vein (IJV) ultrasound studies on agricultural workers in a field-based research setting could assess volume status during a hydration intervention. METHODS We performed pre- and post-work shift IJV ultrasound images on 30 agricultural workers. The IJV collapsibility index values were <39% (euvolemic) or ≥39% (hypovolemic). RESULTS Of the water group, 13% (2/15) had an IJV collapsibility index ≥39%, and this increased to 19% (3/16) by the end of the work shifts. The electrolyte group did not have any workers start the work shift with an IJV collapsibility index ≥39%; however, at the postshift assessment, 15% (2/13) were hypovolemic. CONCLUSION Internal jugular vein ultrasounds may have the potential to be a useful tool to determine volume status in field-based research settings. Further investigation is needed to confirm these findings.
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Affiliation(s)
- Jonathan J Suarez
- From the Division of Renal Medicine, Department of Medicine, Emory University, Atlanta, Georgia (J.J.S., J.M.S.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia (L.E.); Rollins School of Public Health, Emory University, Atlanta, Georgia (A.R.R.); Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (N.X.); and Farmworker Association of Florida, Apopka, Florida (N.X., M.C.H., V.H., L.M.C., R.C.C.)
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7
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Kodikara P, Walker R, Wilson S. Renal physiology and kidney injury during intense (CrossFit®) exercise. Intern Med J 2023; 53:1180-1187. [PMID: 34935262 DOI: 10.1111/imj.15667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND High-intensity training (HIT) programmes are popularly associated with improvements in exercise efficiency and body composition, although, at extremes, have been accompanied by concerns of secondary rhabdomyolysis and severe acute kidney injury (AKI). Beyond the anecdotal, robust literature on the physiological impact of HIT on renal function is currently limited. AIMS To investigate the acute impact of high-intensity (CrossFit®) training on renal function, and to evaluate the incidence of AKI by Risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) criteria following CrossFit® training. METHODS Clinical and biochemical parameters were measured in 22 healthy adults before and after two CrossFit® workouts: 'Fran' (12 men, 10 women) and 'Macho Man' (9 men, 4 women). RESULTS Serum creatinine increased by 16 ± 10 μmol/L following Fran and 18 ± 12 μmol/L following Macho Man (P < 0.05). Cystatin C did not change significantly following Fran and increased by 0.06 ± 0.06 mg/L (P < 0.05) following Macho Man. AKI, as defined by RIFLE 'Risk' criteria, was observed in 5/22 (23%) participants following Fran and 5/13 (38%) participants following Macho Man. Urinary albumin/creatinine ratio rose by 18.7 ± 18.3 and 5.2 ± 6.0 mg/mmol following Fran and Macho Man respectively off non-albuminuric baselines (P < 0.05). CONCLUSIONS Intense (CrossFit®) exercise is associated with significant metabolic demands and alterations in parameters of renal physiology and function. The observed rise in both conventional and novel biomarkers of renal function following the workout Macho Man specifically might indicate a degree of transient subclinical functional impairment with CrossFit®-type training.
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Affiliation(s)
- Pamodi Kodikara
- Department of Renal Medicine, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Rowan Walker
- Department of Renal Medicine, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Scott Wilson
- Department of Renal Medicine, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
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Trivic T, Roklicer R, Zenic N, Modric T, Milovancev A, Lukic-Sarkanovic M, Maksimovic N, Bianco A, Carraro A, Drid P. Rapid weight loss can increase the risk of acute kidney injury in wrestlers. BMJ Open Sport Exerc Med 2023; 9:e001617. [PMID: 37397266 PMCID: PMC10314685 DOI: 10.1136/bmjsem-2023-001617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 07/04/2023] Open
Abstract
Objective Restrictive diets, forced starvation or voluntary weight loss are attracting more and more attention from scientists. Overall trends show that about 80% of combat sports athletes use specific methods of reducing body mass. Rapid weight loss could be a risk factor for kidney-related adverse outcomes. This study aimed to examine the impact of high-intensity specific training combined with rapid weight loss in the first and without rapid weight loss in the second phases on body composition and biochemical markers of kidney function. Methods The study was conducted on 12 male wrestlers. Kidney function markers were measured, including blood urea nitrogen, serum creatinine, uric acid and serum Cystatin-C. Alterations in analysed markers were noted in both phases of the research. Results According to the data, a significant increase was noted in blood urea nitrogen (p=0.002), uric acid (p=0.000) and serum creatinine (p=0.006) during the first phase in comparison with the second phase. The levels of serum Cystatin-C were slightly elevated after both phases compared with the initial measurement. Conclusion It is evident that high-intensity specific training combined with rapid weight loss significantly affects the increase in kidney function markers compared with identical training without rapid weight loss. The findings in this study suggest that rapid body mass reduction is associated with an increased risk of acute kidney injury in wrestlers.
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Affiliation(s)
- Tatjana Trivic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Roberto Roklicer
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
- Faculty of Education, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Natasa Zenic
- Faculty of Kinesiology, University of Split, Split, Croatia
| | - Toni Modric
- Faculty of Kinesiology, University of Split, Split, Croatia
| | - Aleksandra Milovancev
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Mirka Lukic-Sarkanovic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Intensive Therapy and Pain Therapy, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Nemanja Maksimovic
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Attilio Carraro
- Faculty of Education, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
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9
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Snape D, Wainwright B, Woods DR, O'Hara JP. Reliability of Biomarkers of Physiological Stress at Rest and Post-exertional Heat Stress. Int J Sports Med 2023; 44:184-191. [PMID: 35777726 DOI: 10.1055/a-1890-0993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of this study was to assess the reliability of blood biomarkers that can signify exercise-induced heat stress in hot conditions. Fourteen males completed two heat stress tests separated by 5-7 days. Venous blood was drawn pre- and post- heat stress for the concentration of normetanephrine, metanephrine, serum osmolality, copeptin, kidney-injury molecule 1, and neutrophil gelatinase-associated lipocalin. No biomarker, except copeptin, displayed systematic trial order bias (p≥0.05). Normetanephrine, copeptin and neutrophil gelatinase-associated lipocalin presented acceptable reliability (CV range: 0.9-14.3%), while greater variability was present in metanephrine, osmolality and kidney-injury molecule 1 (CV range: 28.6-43.2%). Normetanephrine exhibited the largest increase (p<0.001) in response to heat stress (trial 1=1048±461 pmol. L-1; trial 2=1067±408 pmol. L-1), whilst kidney-injury molecule 1 presented trivial changes (trial 1=-4±20 ng. L-1; trial 2=2 ± 16 ng. L-1, p>0.05). Normetanephrine, copeptin, and neutrophil gelatinase-associated lipocalin demonstrated good reliability and sensitivity to an acute bout of heat stress. These biomarkers may be suitable for application in laboratory and field research to understand the efficacy of interventions that can attenuate the risk of thermal injury whilst exercising in the heat.
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Affiliation(s)
- Daniel Snape
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - Barney Wainwright
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - David R Woods
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland.,Academic Medicine, Royal Centre for Defence Medicine, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - John Paul O'Hara
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland
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Milovančev A, Miljković T, Ilić A, Stojšić Milosavljević A, Petrović M, Roklicer R, Lakičević N, Trivić T, Drid P. Disrupting arrhythmia in a professional male wrestler athlete after rapid weight loss and high-intensity training-Case report. Front Cardiovasc Med 2023; 10:1091603. [PMID: 36760566 PMCID: PMC9905426 DOI: 10.3389/fcvm.2023.1091603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/09/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Physiological heart adaptations may lead to increased susceptibility to arrhythmia in athletes. Furthermore, vigorous training and method like rapid weight loss (RWL) in combat sports could pose additional risks. This case represents how routine cardiovascular screening during high-risk methods like RWL and high-intensity training (HIT) reveal abrupt ventricular arrhythmias in a young athlete. Case report We report a case of a 20-year-old male wrestler athlete who developed disrupting arrhythmia during RWL and HIT. The study included: a medical exam, 12 lead electrocardiograms (ECG), transthoracic echocardiogram (ECHO), and 24 h of continuous ECG monitoring in baseline, phase one (P1), (in which the athlete had to simulate RWL through vigorous training and dietary intervention and HIT) and phase two (P2), (with the same HIT protocol performed without the RWL procedure). Baseline laboratory analyses were without abnormalities, ECG showed sinus rhythm with one premature atrial contraction (PAC) and ECHO showed signs of concentric remodeling with preserved systolic, diastolic function, and global longitudinal strain. After P1 RWL simulation, he lost 5.15% of body weight in 3 days, which resulted in lower blood glucose levels, higher urea, creatinine, creatine kinase (CK), CK-MB levels, and slightly increased levels of NT pro-BNP, ECG revealed sinus rhythm with one ventricular premature beat (VPB), 24-h continuous electrocardiogram (ECG) revealed frequent ventricular premature beats (PVB) 2,150/ 24 h, with two couplets, and 8 PAC. After an advised 4-week period of de-training continuous 24 h, ECG monitoring was improved with only occasional PVB. The 24 h continuous ECG monitoring was repeated after HIT and revealed even more frequent PVB, 5% of all beats for 24 h, 4,205 in total, and almost all VPB were in bigeminy and trigeminy. The athlete was advised against RWL and extremely vigorous exercise and for regular, frequent checkups with occasional ECG monitoring during and after exercise. Conclusion The short and long-term implication of abrupt ventricular arrhythmias provoked by intensive training and methods like RWL is unknown. We postulate that cardiovascular screening is necessitated, especially during high-risk methods like RWL and HIT, in helping us prevent adverse outcomes and come to individual-based clinical making decisions for each athlete.
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Affiliation(s)
- Aleksandra Milovančev
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia,Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia,*Correspondence: Aleksandra Milovančev ✉
| | - Tatjana Miljković
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia,Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Aleksandra Ilić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia,Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Anastazija Stojšić Milosavljević
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia,Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Milovan Petrović
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia,Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia,Milovan Petrović ✉
| | - Roberto Roklicer
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Nemanja Lakičević
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Tatjana Trivić
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
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11
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Wensley MR, Woodworth JC, Tokach MD, Goodband RD, DeRouchey JM, Gebhardt JT. Effect of early vs. late maturing sire lines and creep feeding on the cortisol response, intestinal permeability, and growth performance of nursery and finishing pigs. J Anim Sci 2023; 101:skad169. [PMID: 37226536 PMCID: PMC10259252 DOI: 10.1093/jas/skad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/18/2023] [Indexed: 05/26/2023] Open
Abstract
A total of 21 litters (11 early and 10 late maturing Duroc × DNA 241) resulting in 241 pigs were used in 170 d trial to determine the effect of sire lines selected for either early or late maturing growth rates and creep feeding on the cortisol concentration, intestinal permeability, and growth performance of nursery and finishing pigs. Treatments were arranged in a 2 × 2 factorial with main effect of Duroc sire line (early or late maturing) and creep feeding (with or without). Creep feed was provided for 14 d prior to weaning. After weaning (approximately 21 d of age; initially 6.4 kg), no interactions were observed for blood cortisol. However, blood cortisol levels were increased (P = 0.011) in late maturing pigs compared to early maturing pigs. A lower percentage (P < 0.001) of early maturing pigs lost weight 3 d post-weaning compared to late maturing pigs. Likewise, early maturing pigs had improved (P < 0.001) average daily gain (ADG) and average daily feed intake (ADFI) during the first 3 d in the nursery and also had increased ADFI (P < 0.001) from days 2 to 14 in the nursery. Creep feeding had no effect on initial nursery performance. On day 7, after a 2-h fast, a subsample of pigs was administered an oral gavage of lactulose and mannitol dissolved in distilled water. No differences by sire line, creep feeding, or their interactions were observed in lactulose:mannitol ratio. For overall nursery growth performance, an interaction was observed for ADG (P = 0.007) and ADFI (P < 0.001), with creep feed providing a benefit in late maturing pigs, but not in early maturing pigs. Early maturing pigs had poorer gain-to-feed ratio (G:F) (P < 0.001) than late maturing pigs. For overall finishing performance, an interaction was observed for ADG (P = 0.037) and ADFI (P = 0.007), with creep feed providing a benefit in late maturing pigs, but not in early maturing pigs. This resulted in an interaction for final body weight (P = 0.005), with late maturing pigs that did not receive creep feed having decreased market weights (P ≤ 0.003) compared to the other treatments. In summary, early maturing pigs had decreased cortisol concentration at weaning and improved ADG and ADFI until approximately 100 kg, at which point late maturing pigs began to exhibit greater ADG. Late maturing pigs had improved G:F from 46 d of age until market. Interestingly, creep feeding late maturing pigs resulted in increased day 170 weight compared with providing no creep feed, whereas creep feed did not impact early maturing pigs (sire line × creep feed interaction, P < 0.005).
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Affiliation(s)
- Madie R Wensley
- Department of Animal Sciences and Industry, College of Agriculture, Kansas State University, Manhattan, KS 66506-0201, USA
| | - Jason C Woodworth
- Department of Animal Sciences and Industry, College of Agriculture, Kansas State University, Manhattan, KS 66506-0201, USA
| | - Mike D Tokach
- Department of Animal Sciences and Industry, College of Agriculture, Kansas State University, Manhattan, KS 66506-0201, USA
| | - Robert D Goodband
- Department of Animal Sciences and Industry, College of Agriculture, Kansas State University, Manhattan, KS 66506-0201, USA
| | - Joel M DeRouchey
- Department of Animal Sciences and Industry, College of Agriculture, Kansas State University, Manhattan, KS 66506-0201, USA
| | - Jordan T Gebhardt
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-0201, USA
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12
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Komka Z, Szilágyi B, Molnár D, Sipos B, Tóth M, Sonkodi B, Ács P, Elek J, Szász M. Exercise-related hemoconcentration and hemodilution in hydrated and dehydrated athletes: An observational study of the Hungarian canoeists. PLoS One 2022; 17:e0277978. [PMID: 36584041 PMCID: PMC9803156 DOI: 10.1371/journal.pone.0277978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 11/08/2022] [Indexed: 12/31/2022] Open
Abstract
Hemoconcentration during exercise is a well-known phenomenon, however, the extent to which dehydration is involved is unclear. In our study, the effect of dehydration on exercise-induced hemoconcentration was examined in 12 elite Hungarian kayak-canoe athletes. The changes of blood markers were examined during acute maximal workload in hydrated and dehydrated states. Dehydration was achieved by exercise, during a 120-minute extensive-aerobic preload. Our research is one of the first studies in which the changes in blood components were examined with a higher time resolution and a wider range of the measured parameters. Hydration status had no effect on the dynamics of hemoconcentration during both the hydrated (HS) and dehydrated (DHS) load, although lower maximal power output were measured after the 120-minute preload [HS Hemoglobin(Hgb)Max median 17.4 (q1 17.03; q3 17.9) g/dl vs. DHS HgbMax median 16.9 (q1 16.43; q3 17.6) g/dl (n.s); HS Hematocrit(Hct)Max 53.50 (q1 52.28; q3 54.8) % vs. DHS HctMax 51.90 (q1 50.35; q3 53.93) % (n.s)]. Thirty minutes after the maximal loading, complete hemodilution was confirmed in both exercises. Dehydration had no effect on hemoconcentration or hemodilution in the recovery period [HS HgbR30' 15.7 (q1 15.15; q3 16.05) g/dl (n.s.) vs. DHS HgbR30' 15.75 (q1 15.48; q3 16.13) g/dl (n.s.), HS HctR30' 48.15 (q1 46.5; q3 49.2) % vs. DHS HctR30' 48.25 (q1 47.48; q3 49.45) % (n.s.)], however, plasma osmolality did not follow a corresponding decrease in hemoglobin and hematocrit in the dehydrated group. Based on our data, metabolic products (glucose, lactate, sodium, potassium, chloride, bicarbonate ion, blood urea nitrogen) induced osmolality may not play a major role in the regulation of hemoconcentration and post-exercise hemodilution. From our results, we can conclude that hemoconcentration depends mainly on the intensity of the exercise.
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Affiliation(s)
- Zsolt Komka
- Department of Health Sciences and Sports Medicine, Hungarian University of Sports Science, Budapest, Hungary
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Hungarian Canoe Federation, Budapest, Hungary
- * E-mail:
| | - Brigitta Szilágyi
- Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
- Institute of Mathematics and Statistical Modelling, Corvinus University of Budapest, Budapest, Hungary
| | - Dóra Molnár
- Hungarian Canoe Federation, Budapest, Hungary
| | - Bence Sipos
- Faculty of Natural Sciences Department of Geometry, Budapest University of Technology and Economics, Budapest, Hungary
| | - Miklós Tóth
- Department of Health Sciences and Sports Medicine, Hungarian University of Sports Science, Budapest, Hungary
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
- Szentágothai Research Center, Pécs, Hungary
| | - Balázs Sonkodi
- Department of Health Sciences and Sports Medicine, Hungarian University of Sports Science, Budapest, Hungary
| | - Pongrác Ács
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- Szentágothai Research Center, Pécs, Hungary
| | - János Elek
- Department of Inorganic and Analytical Chemistry, University of Debrecen, Debrecen, Hungary
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Tidmas V, Brazier J, Bottoms L, Muniz D, Desai T, Hawkins J, Sridharan S, Farrington K. Ultra-Endurance Participation and Acute Kidney Injury: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16887. [PMID: 36554767 PMCID: PMC9779673 DOI: 10.3390/ijerph192416887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Increasingly popular, ultra-endurance participation exposes athletes to extremely high levels of functional and structural damage. Ultra-endurance athletes commonly develop acute kidney injury (AKI) and other pathologies harmful to kidney health. There is strong evidence that non-steroidal anti-inflammatory drugs, common amongst ultra-athletes, is linked to increased risk and severity of AKI and potentially ischaemic renal injury, i.e., acute tubular necrosis. Ultra-endurance participation also increases the risk of exertional rhabdomyolysis, exercise-associated hyponatremia, and gastrointestinal symptoms, interlinked pathologies all with potential to increase the risk of AKI. Hydration and fuelling both also play a role with the development of multiple pathologies and ultimately AKI, highlighting the need for individualised nutritional and hydration plans to promote athlete health. Faster athletes, supplementing nitrates, and being female also increase the risk of developing AKI in this setting. Serum creatinine criteria do not provide the best indicator for AKI for ultra-athletes therefore further investigations are needed to assess the practicality and accuracy of new renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL). The potential of recurring episodes of AKI provide need for further research to assess the longitudinal renal health impact of ultra-participation to provide appropriate advice to athletes, coaches, medical staff, and event organisers.
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Affiliation(s)
- Victoria Tidmas
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Jon Brazier
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Lindsay Bottoms
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Daniel Muniz
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Terun Desai
- Department of Psychology, Sport, and Geography, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Janine Hawkins
- Centre for Health Services and Clinical Research, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Sivakumar Sridharan
- Centre for Health Services and Clinical Research, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
- Renal Unit, Lister Hospital, East and North Herts Trust, Stevenage SG1 4AB, UK
| | - Ken Farrington
- Centre for Health Services and Clinical Research, De Havilland Campus, University of Hertfordshire, Hatfield AL10 9EU, UK
- Renal Unit, Lister Hospital, East and North Herts Trust, Stevenage SG1 4AB, UK
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14
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Kozub FM, Faller J, Kozub JM. Using Autoregulation to Safely Return to Weightlifting During Cancer Treatments. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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15
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Jesuthasan A, Ali A, Lee JKW, Rutherfurd-Markwick K. Assessment of Changes in Physiological Markers in Different Body Fluids at Rest and after Exercise. Nutrients 2022; 14:nu14214685. [PMID: 36364948 PMCID: PMC9654217 DOI: 10.3390/nu14214685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Physiological and biological markers in different body fluids are used to measure the body’s physiological or pathological status. In the field of sports and exercise medicine, the use of these markers has recently become more popular for monitoring an athlete’s training response and assessing the immediate or long-term effects of exercise. Although the effect of exercise on different physiological markers using various body fluids is well substantiated, no article has undertaken a review across multiple body fluids such as blood, saliva, urine and sweat. This narrative review aims to assess various physiological markers in blood, urine and saliva, at rest and after exercise and examines physiological marker levels obtained across similar studies, with a focus on the population and study methodology used. Literature searches were conducted using PRISMA guidelines for keywords such as exercise, physical activity, serum, sweat, urine, and biomarkers, resulting in an analysis of 15 studies for this review paper. When comparing the effects of exercise on physiological markers across different body fluids (blood, urine, and saliva), the changes detected were generally in the same direction. However, the extent of the change varied, potentially as a result of the type and duration of exercise, the sample population and subject numbers, fitness levels, and/or dietary intake. In addition, none of the studies used solely female participants; instead, including males only or both male and female subjects together. The results of some physiological markers are sex-dependent. Therefore, to better understand how the levels of these biomarkers change in relation to exercise and performance, the sex of the participants should also be taken into consideration.
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Affiliation(s)
- Amalini Jesuthasan
- School of Health Sciences, Massey University, Auckland 0745, New Zealand
| | - Ajmol Ali
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0745, New Zealand
- Centre for Metabolic Health Research, Massey University, Auckland 0745, New Zealand
| | - Jason Kai Wei Lee
- Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), 1 CREATE Way, Singapore 138602, Singapore
| | - Kay Rutherfurd-Markwick
- School of Health Sciences, Massey University, Auckland 0745, New Zealand
- Centre for Metabolic Health Research, Massey University, Auckland 0745, New Zealand
- Correspondence: ; Tel.: +64-9-213-6646
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16
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Parker L, Ang T, Morrison DJ, Lee NJ, Levinger I, Keske MA. Prior aerobic exercise mitigates the decrease in serum osteoglycin and lipocalin-2 following high-glucose mixed-nutrient meal ingestion in young men. Am J Physiol Endocrinol Metab 2022; 323:E319-E332. [PMID: 35767699 DOI: 10.1152/ajpendo.00025.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Osteoglycin (OGN) and lipocalin-2 (LCN2) are hormones that can be secreted by bone and have been linked to glucose homeostasis in rodents. However, the endocrine role of these hormones in humans is contradictory and unclear. We examined the effects of exercise and meal ingestion on circulating serum OGN and LCN2 levels in eight healthy males {age: 28 [25, 30] years [median ± interquartile range (IQR)] and body mass index [BMI]: 24.3 [23.6, 25.5] kg/m2}. In a randomized crossover design, participants ingested a high-glucose (1.1 g glucose/kg body wt) mixed-nutrient meal (45% carbohydrate, 20% protein, and 35% fat) on a rest-control day and 3 and 24 h after aerobic cycling exercise (1 h at 70%-75% V̇o2peak). Acute aerobic exercise increased serum LCN2 levels immediately after exercise (∼61%), which remained elevated 3-h postexercise (∼55%). In contrast, serum OGN remained similar to baseline levels throughout the 3-h postexercise recovery period. The ingestion of a high-glucose mixed-nutrient meal led to a decrease in serum OGN at 90-min (approximately -17%) and 120-min postprandial (approximately -44%), and a decrease in LCN2 at 120-min postprandial (approximately -26%). Compared with the control meal, prior exercise elevated serum OGN and LCN2 levels at 120-min postprandial when the meal was ingested 3-h (OGN: ∼74% and LCN2: ∼68%) and 24-h postexercise (OGN: ∼56% and LCN2: ∼16%). Acute exercise increases serum LCN2 and attenuates the postprandial decrease in OGN and LCN2 following high-glucose mixed-nutrient meal ingestion. The potential endocrine role of circulating OGN and LCN2 in humans warrants further investigation.NEW & NOTEWORTHY We provide novel evidence that OGN and LCN2 decrease 120 min after ingesting a high-glucose mixed-nutrient meal in healthy adults. Acute aerobic exercise increases circulating LCN2 for up to 3-h postexercise, whereas circulating OGN remains similar to baseline. Despite differing postexercise responses, postprandial LCN2 and OGN are elevated when the high-glucose meal is ingested 3-h and 24-h postexercise. Findings support that OGN and LCN2 are dynamically linked to energy homeostasis in humans.
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Affiliation(s)
- Lewan Parker
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Teddy Ang
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Dale J Morrison
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Nicola J Lee
- Garvan Institute of Medical Research, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia
- St. Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Footscray, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia
| | - Michelle A Keske
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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17
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The effect of interval and continuous work on markers of acute kidney injury in a hot environment. Eur J Appl Physiol 2022; 122:2437-2450. [PMID: 35999474 DOI: 10.1007/s00421-022-05030-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/15/2022] [Indexed: 12/26/2022]
Abstract
PURPOSE To examine the effect of high-intensity interval work (HIIW) and moderate-intensity continuous work (MICW) on markers of acute kidney injury (AKI) and kidney function in a hot environment. METHODS Nine males completed 2 h of work (2 × 60 min with 10 min passive rest) in a hot environment (40 °C and 15% relative humidity) as either HIIW [2 min at 80% peak oxygen consumption (VO2peak) and 3 min at 30% VO2peak] or MICW (matched for total work of HIIW). Blood and urine samples were collected immediately before (Pre), after (Post), 1 h (1 h Post), and 24 h after (24 h Post) the trials. Urine flow rate (UFR), creatinine clearance, insulin-like growth factor binding protein 7 (IGFBP7), urinary neutrophil gelatinase-associated lipocalin (uNGAL), and urinary kidney injury marker 1 (uKIM-1) were measured to assess kidney function and injury. RESULTS Log IGFBP7 (p < 0.01), log uNGAL (p < 0.01), and log uKIM-1 (p = 0.01) all displayed a main effect for time after both HIIW and MICW. IGFBP7 (p = 0.01) and uKIM-1 (p < 0.01), corrected for Uosm, were higher after HIIW compared to MICW at Post, while IGFBP7 was also higher 1 h Post after HIIW compared to MICW (p = 0.02). UFR significantly decreasing from Pre to Post (p < 0.01) and 1 h Post (p < 0.01), but no main effect for condition (p = 0.53). CONCLUSION Both HIIW and MICW in a hot environment caused an increase in biomarkers of kidney injury (IGFBP7, KIM-1, and NGAL), but HIIW may have a greater impact on biomarkers related to AKI.
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18
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Li M, Shu W, Amaerjiang N, Xiao H, Zunong J, Vermund SH, Huang D, Hu Y. Interaction of Hydration Status and Physical Activity Level on Early Renal Damage in Children: A Longitudinal Study. Front Nutr 2022; 9:910291. [PMID: 35811990 PMCID: PMC9260418 DOI: 10.3389/fnut.2022.910291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/23/2022] [Indexed: 12/16/2022] Open
Abstract
BackgroundOptimal water intake positively affects various aspects of human physiology, especially renal function. Physical activity (PA) may have an impact on hydration status and renal health, but the interaction of hydration status and PA level on renal function is not well-studied in children.MethodsWe conducted four waves of urine assays in our child cohort (PROC) study from October 2018 to November 2019 in Beijing, China. We measured urinary specific gravity, β2-microglobulin (β2-MG), and microalbumin (MA) excretion to assess hydration status and renal damage in the context of PA level and other covariates among 1,914 primary school children. We determined the associations of renal damage with the interaction of hydration status and PA level using generalized linear mixed-effects models.ResultsThe prevalence of dehydration was 35.0%, 62.1%, 63.9%, and 63.3%, and the prevalence of insufficient PA was 86.2%, 44.9%, 90.4%, and 90.2% from wave 1 to wave 4 among 1,914 primary school children. From wave 1 to wave 4, the prevalence of renal tubular damage had a significant increasing trend of 8.8%, 15.9%, 25.7%, and 29.0% (Z = 16.9, P < 0.001), while the prevalence of glomerular damage revealed a declining trend of 5.6%, 5.5%, 4.4%, and 4.1% (Z = −2.4, P = 0.016). There were stable longitudinal associations of renal tubular and glomerular damage with hydration status (euhydration: OR = 0.50 and 0.33, respectively) but not with PA level. In multivariate analysis, significant interactions of hydration status and PA level were noted with renal tubular damage (β = 0.43, P = 0.014) and glomerular damage (β = 0.60, P = 0.047). Children with euhydration and insufficient PA were less likely to have renal tubular damage (OR = 0.46, 95% CI: 0.39, 0.53) or glomerular damage (OR = 0.28, 95% CI: 0.20, 0.39); children with euhydration and sufficient PA were also less likely to have renal tubular damage (OR = 0.57, 95% CI: 0.44, 0.75) or glomerular damage (OR = 0.47, 95% CI: 0.30, 0.74), adjusting for age, sex, BMI z-score, standardized SBP, sleep duration, computer/cell phone screen time, and fruit and vegetable intake.ConclusionChildren with euhydration and either sufficient or insufficient PA were less likely to have early renal damage. Adequate daily water intake for children is important, especially after PA.
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Affiliation(s)
- Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Wen Shu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Huidi Xiao
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Jiawulan Zunong
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Sten H. Vermund
- Office of the Dean, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Dayong Huang
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Dayong Huang
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
- Yifei Hu ;
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Forsse JS, Buckley D, Ismaeel A, Richardson KA, Oliver A, Koutakis P. Effect of Age and Acute-Moderate Intensity Exercise on Biomarkers of Renal Health and Filtration. BIOLOGY 2022; 11:527. [PMID: 35453726 PMCID: PMC9029611 DOI: 10.3390/biology11040527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
Aerobic exercise elicits a multitude of physiological improvements in both healthy and diseased populations. However, acute changes in renal health and filtration with aerobic exercise remain difficult to quantify by traditional biomarkers to estimate glomerular filtration rate (eGFR). This study aimed to determine if an acute bout of moderate-intensity aerobic exercise transiently improves non-traditional biomarkers when compared to traditional biomarkers of renal health and filtration in individuals without cardiometabolic diseases. Thirty-nine participants (n = 18 men; n = 21 women; age 32.5 + 12.6 yr; height 171.1 + 11.4 cm; weight 78.7 + 15.6 kg; BMI 27.1 + 5.8) completed a single bout of moderate-intensity (50-60% HRR) aerobic exercise. Blood and urine samples were collected and compared before and post-exercise. Serum creatinine, urine epidermal growth factor (uEGF), uEGF/urine creatinine ratio (uEGFR), and cystatin C (CyC) were measured. In addition, eGFR-MDRD and the CKD-epidemiology equations were used to analyze renal clearance. Relative to pre-exercise measures: serum creatinine (p = 0.26), uEGF (p = 0.35), and uEGFR (p = 0.09) remained unchanged, whereas cystatin C (p = 0.00) significantly increased post-exercise. CyC eGFR was the only estimator of renal filtration to significantly change (p = 0.04). In conclusion, CyC is the only biomarker of renal health and filtration to significantly increase after aerobic exercise. Further investigation focused on sampling time and exercise-intensity is needed to solidify the current understanding of renal health and filtration.
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Affiliation(s)
- Jeffrey S. Forsse
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX 76706, USA;
- Kinesiology Department, Stephen F. Austin State University, Nacogdoches, TX 75962, USA; (D.B.); (A.O.)
| | - David Buckley
- Kinesiology Department, Stephen F. Austin State University, Nacogdoches, TX 75962, USA; (D.B.); (A.O.)
- Integrative Immunology Laboratory, University of Texas Arlington, Arlington, TX 76019, USA
| | - Ahmed Ismaeel
- Clinical Muscle Biology Lab, Baylor University, Waco, TX 76706, USA;
| | - Kathleen A. Richardson
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX 76706, USA;
| | - Autumn Oliver
- Kinesiology Department, Stephen F. Austin State University, Nacogdoches, TX 75962, USA; (D.B.); (A.O.)
- Edward Via College of Osteopathic Medicine, University of Louisiana Monroe, Monroe, LA 71203, USA
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20
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Redfearn A, McNally J, Brewer H, Doyle E, Schmoelzl S. Using Pen-Side Measurable Blood Parameters to Predict or Identify Dystocic Lambing Events. BIOLOGY 2022; 11:biology11020206. [PMID: 35205072 PMCID: PMC8869090 DOI: 10.3390/biology11020206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 11/23/2022]
Abstract
Simple Summary Prolonged or non-progressive labour is the greatest risk factor for loss of newborn lambs in Australia and poses significant welfare and economic concerns worldwide. In this study, we set out to investigate whether pen-side technology could be used to predict which ewes would be at risk of prolonged labour. In our pilot trial, we found potentially useful markers. We next developed a sampling protocol by looking at changes in candidate markers over time in normal lambing events. Finally, we searched for blood markers that could distinguish between normal and difficult lambing events, sampling pre-birth (estimated one week before birth), at birth (within 3 h) and post-birth (16–26 h). Possible predictors of lambing difficulty were chloride, haematocrit and haemoglobin, sampled one week before birth; creatinine, sampled at birth; and acid–base related parameters after birth. In conclusion, we found that pen-side analysis of blood markers showed promise in identifying dystocic lambing events. More information is required to decide whether pen-side diagnostics could be useful to identify and predict dystocic lambing in the future. Abstract Dystocia is the greatest contributor to neonatal lamb mortality in Australia and poses significant welfare and economic concerns worldwide. In this study, we set out to investigate whether pen-side analysis technology could be employed to detect blood parameters predictive of dystocic labour events in sheep. In a pilot trial, we collected and analysed blood samples in pen-side assays for glucose, lactate, pH, pCO2, pO2, base excess, HCO3, TCO2, sO2, lactate, sodium, potassium, chloride, calcium, urea nitrogen, creatinine, haematocrit, haemoglobin and anion gap. From the pilot data, we identified creatinine, TCO2, chloride and calcium as potentially useful markers. To develop a time course and to establish variability of the selected blood parameters, a time series of samples was collected from 12 ewes, from mid-gestation to 48 h after birth. For the main trial, blood samples were collected at mid- and late gestation for glucose determination and for the full set of blood parameters at three time points before, at and after birth. Possible predictors of lambing difficulty were chloride, haematocrit and haemoglobin, sampled one week before birth; creatinine, sampled at birth; and blood pH and base excess after birth. In conclusion, we found that pen-side analysis of blood markers showed promise in identifying dystocic lambing events.
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Affiliation(s)
- Amellia Redfearn
- FD McMaster Laboratory, Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Armidale, NSW 2350, Australia; (A.R.); (J.M.); (H.B.)
- School of Environmental and Rural Science, University of New England, Armidale, NSW 2351, Australia;
| | - Jody McNally
- FD McMaster Laboratory, Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Armidale, NSW 2350, Australia; (A.R.); (J.M.); (H.B.)
| | - Heather Brewer
- FD McMaster Laboratory, Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Armidale, NSW 2350, Australia; (A.R.); (J.M.); (H.B.)
| | - Emma Doyle
- School of Environmental and Rural Science, University of New England, Armidale, NSW 2351, Australia;
| | - Sabine Schmoelzl
- FD McMaster Laboratory, Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Armidale, NSW 2350, Australia; (A.R.); (J.M.); (H.B.)
- School of Environmental and Rural Science, University of New England, Armidale, NSW 2351, Australia;
- Correspondence:
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21
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Calleja-Romero A, Vicente-Rodríguez G, Garatachea N. Acute effects of long-distance races on heart rate variability and arterial stiffness: A systematic review and meta-analysis. J Sports Sci 2021; 40:248-270. [PMID: 34720045 DOI: 10.1080/02640414.2021.1986276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study systematically reviewed and quantified the effects of running a long-distance race (LDR) on heart rate variability (HRV) and arterial stiffness (AS). All types of races of a distance equal to or greater than a marathon (≥42.2 km) were included. A total of 2,220 articles were identified, 52 were included in the qualitative analysis, and 48 were meta-analysed. The standardised mean difference pre- and post-race of various time-domain and frequency-domain indices of HRV, mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP) and carotid-femoral pulse wave velocity (cfPWV) was calculated. Regarding HRV, there was a significant decrease in most of the variables considered as markers of parasympathetic activity, indicating a shift of autonomic balance towards a reduced vagal tone. Regarding vascular variables, there was a significant drop in blood pressure and reduced AS. In conclusion, running an LDR seems to have a considerable acute effect on the autonomic nervous system, haemodynamics, and vascular properties. The observed effects could be categorised within the expected acute responses to long-lasting, strenuous exercise.
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Affiliation(s)
- Alberto Calleja-Romero
- Faculty of Health and Sport Science (Fcsd, Ronda Misericordia 5, 22001-Huesca, Spain), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
| | - Germán Vicente-Rodríguez
- Faculty of Health and Sport Science (Fcsd, Ronda Misericordia 5, 22001-Huesca, Spain), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Growth, Exercise, Nutrition and Development Group and IIS-Aragon, Spain.,Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciber-obn), Madrid, Spain.,Instituto Agroalimentario De Aragón -ia2- (Cita-universidad De Zaragoza), Zaragoza, Spain
| | - Nuria Garatachea
- Faculty of Health and Sport Science (Fcsd, Ronda Misericordia 5, 22001-Huesca, Spain), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Growth, Exercise, Nutrition and Development Group and IIS-Aragon, Spain.,Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciber-obn), Madrid, Spain.,Instituto Agroalimentario De Aragón -ia2- (Cita-universidad De Zaragoza), Zaragoza, Spain
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22
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Rojas-Valverde D, Martínez-Guardado I, Sánchez-Ureña B, Timón R, Scheer V, Pino-Ortega J, Olcina G. Outpatient Assessment of Mechanical Load, Heat Strain and Dehydration as Causes of Transitional Acute Kidney Injury in Endurance Trail Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910217. [PMID: 34639516 PMCID: PMC8508486 DOI: 10.3390/ijerph181910217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/12/2021] [Accepted: 09/21/2021] [Indexed: 12/11/2022]
Abstract
Background: This study aimed to globally assess heat strain, dehydration, and mechanical load as acute kidney injury (AKI) indicators in amateur endurance trail athletes during a 35.3 km run. Methods: Thirty amateur experienced trail runners completed an endurance trail run (total positive ascend 1815 m). The following assessments were performed at four measurement time points (pre-, during, immediately post [-post0h], and after 24 h of the finish of the run [-post24h]): serum test (creatinine, blood ureic nitrogen, albumin, creatine kinase, blood ureic nitrogen: creatinine ratio, creatinine clearance, and glomerular filtration rate), mechanical load (impacts and Player Load), heat strain and dehydration (hematocrit, urine solids, body weight and urine specific gravity), pain and exertion perception (rate of perceived exertion, lumbar and bipodal, and one-leg squat pain), and urinalysis (pH, protein, glucose, erythrocytes, and urine specific gravity). Results: There were pre vs. post0h changes in all serum biomarkers (F = 5.4–34.45, p < 0.01). The change in these biomarkers correlated with an increase in mechanical load indicators (r = 0.47–59, p < 0.05). A total of 40% and 23.4% of participants presented proteinuria and hematuria, respectively. Pain and perceived exertion increased significantly due to effort made during the endurance trail running (F = 4.2–176.4, p < 0.01). Conclusions: Endurance trail running may lead to an increase in blood and urine indicators of transitional AKI. The difference in blood and urine markers was significantly related to the mechanical load during running, suggesting potential kidney overload and cumulative mechanical load.
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Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 86-3000, Costa Rica
- Clínica de Lesiones Deportivas (Rehab & Readapt), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional de Costa Rica, Heredia 86-3000, Costa Rica
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain; (R.T.); (G.O.)
- Correspondence: (D.R.-V.); (I.M.-G.); Tel.: +506-88250219 (D.R.-V.)
| | - Ismael Martínez-Guardado
- Faculty of Life and Natural Sciences, University of Nebrija, 28015 Madrid, Spain
- Correspondence: (D.R.-V.); (I.M.-G.); Tel.: +506-88250219 (D.R.-V.)
| | - Braulio Sánchez-Ureña
- Programa de Ciencias del Ejercicio y la Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia 86-3000, Costa Rica;
| | - Rafael Timón
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain; (R.T.); (G.O.)
| | - Volker Scheer
- Ultra Sports Science Foundation, 69310 Pierre-Bénite, France;
| | - José Pino-Ortega
- Biovetmed & Sportsci Research Group, University of Murcia, 30720 San Javier, Spain;
| | - Guillermo Olcina
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain; (R.T.); (G.O.)
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23
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Juett LA, Midwood KL, Funnell MP, James LJ, Mears SA. Hypohydration produced by high-intensity intermittent running increases biomarkers of renal injury in males. Eur J Appl Physiol 2021; 121:3485-3497. [PMID: 34528132 PMCID: PMC8571244 DOI: 10.1007/s00421-021-04804-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/31/2021] [Indexed: 01/20/2023]
Abstract
Purpose Whilst there is evidence to suggest that hypohydration caused by physical work in the heat increases renal injury, whether this is the case during exercise in temperate conditions remains unknown. This study investigated the effect of manipulating hydration status during high-intensity intermittent running on biomarkers of renal injury. Methods After familiarisation, 14 males (age: 33 ± 7 years; V̇O2peak: 57.1 ± 8.6 ml/kg/min; mean ± SD) completed 2 trials in a randomised cross-over design, each involving 6, 15 min blocks of shuttle running (modified Loughborough Intermittent Shuttle Test protocol) in temperate conditions (22.3 ± 1.0 °C; 47.9 ± 12.9% relative humidity). During exercise, subjects consumed either a volume of water equal to 90% of sweat losses (EU) or 75 mL water (HYP). Body mass, blood and urine samples were taken pre-exercise (baseline/pre), 30 min post-exercise (post) and 24 h post-baseline (24 h). Results Post-exercise, body mass loss, serum osmolality and urine osmolality were greater in HYP than EU (P ≤ 0.024). Osmolality-corrected urinary kidney injury molecule-1 (uKIM-1) concentrations were increased post-exercise (P ≤ 0.048), with greater concentrations in HYP than EU (HYP: 2.76 [1.72–4.65] ng/mOsm; EU: 1.94 [1.1–2.54] ng/mOsm; P = 0.003; median [interquartile range]). Osmolality-corrected urinary neutrophil gelatinase-associated lipocalin (uNGAL) concentrations were increased post-exercise (P < 0.001), but there was no trial by time interaction effect (P = 0.073). Conclusion These results suggest that hypohydration produced by high-intensity intermittent running increases renal injury, compared to when euhydration is maintained, and that the site of this increased renal injury is at the proximal tubules.
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Affiliation(s)
- Loris A Juett
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Katharine L Midwood
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Mark P Funnell
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Stephen A Mears
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.
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24
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Ertelt A, Merle R, Stumpff F, Bollinger L, Liertz S, Weber C, Gehlen H. Evaluation of Different Blood Parameters From Endurance Horses Competing at 160 km. J Equine Vet Sci 2021; 104:103687. [PMID: 34416987 DOI: 10.1016/j.jevs.2021.103687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 01/02/2023]
Abstract
The purpose of this study was to assess a change in different blood parameters before and after a 160 km endurance race and to evaluate differences in cardiac biomarkers between horses that completed the race and horses that did not. The study population consisted of 52 healthy endurance horses. Horses participating in the study were assigned to three groups: horses that successfully completed the race ("finishers"), horses that failed to qualify at the veterinary check for primarily metabolic reasons ("metabolic") and horses that failed to qualify at the veterinary check for primarily gait related reasons ("gait related"). The latter two groups were combined to form a final group of "non-finishers" that were excluded for either "gait related" or "metabolic" disorders. Venous blood samples were taken before and after the endurance race. Serum and EDTA-plasma were analyzed for cardiac troponin I (cTNI), heart fatty acid binding protein (HFABP), alpha-hydroxybutyrate dehydrogenase (α-HBDH), atrial natriuretic peptide (ANP), lactate dehydrogenase (LDH), symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA). Lactate dehydrogenase (P = .001), SDMA (P= .001) and ADMA (P= .002) increased significantly after the endurance race in the finisher group. A significant increase in cTNI and α-HBDH concentration after the endurance race compared to the values before the endurance race was detected in the finisher (P= .001, P= .001) and gait related group (P= .002, P= .007). The longer the distance completed, the more these five blood parameters increased. No differences between the groups could be found and none of the measured blood parameters showed significant differences among groups before or after racing.
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Affiliation(s)
- Antonia Ertelt
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Berlin, Germany.
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universitaet Berlin, Berlin, Germany
| | - Friederike Stumpff
- Institute of Veterinary Physiology, Freie Universitaet Berlin, Berlin, Germany
| | - Lena Bollinger
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Berlin, Germany
| | - Sarah Liertz
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Berlin, Germany
| | - Corinna Weber
- Laboklin Veterinary Diagnostic Laboratory, Bad Kissingen, Germany
| | - Heidrun Gehlen
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Berlin, Germany
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25
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Chapman CL, Hess HW, Lucas RAI, Glaser J, Saran R, Bragg-Gresham J, Wegman DH, Hansson E, Minson CT, Schlader ZJ. Occupational heat exposure and the risk of chronic kidney disease of nontraditional origin in the United States. Am J Physiol Regul Integr Comp Physiol 2021; 321:R141-R151. [PMID: 34161738 DOI: 10.1152/ajpregu.00103.2021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.
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Affiliation(s)
| | - Hayden W Hess
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jason Glaser
- La Isla Network, Washington, D.C.,Responsible Business Center at Birkbeck, University of London, London, United Kingdom
| | - Rajiv Saran
- Division of Nephrology and the Kidney Epidemiology and Cost Center, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Jennifer Bragg-Gresham
- Division of Nephrology and the Kidney Epidemiology and Cost Center, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - David H Wegman
- Department of Epidemiology, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Erik Hansson
- La Isla Network, Washington, D.C.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Zachary J Schlader
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
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26
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Houser MC, Mac V, Smith DJ, Chicas RC, Xiuhtecutli N, Flocks JD, Elon L, Tansey MG, Sands JM, McCauley L, Hertzberg VS. Inflammation-Related Factors Identified as Biomarkers of Dehydration and Subsequent Acute Kidney Injury in Agricultural Workers. Biol Res Nurs 2021; 23:676-688. [PMID: 34018403 DOI: 10.1177/10998004211016070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Globally, there is increasing recognition that agricultural workers are at risk for chronic kidney disease of unknown etiology (CKDu). Recurrent heat exposure, physical exertion, dehydration, muscle damage, and inflammation are hypothesized to contribute to the development of CKDu, but the relative importance of these processes and the interactions among them remain unclear. Moreover, there is a need to identify biomarkers that could distinguish individuals who are at greatest risk for kidney damage to target preventative interventions for CKDu. In this study, we evaluated dehydration and markers of inflammation, muscle damage, and renal function in agricultural workers at a non-workday baseline assessment. Urine specific gravity and kidney function were measured before and after work shifts on three subsequent days, and heat index, core body temperature, and heart rate were monitored during the work shifts. A combination of direct comparisons and machine learning algorithms revealed that reduced levels of uromodulin and sodium in urine and increased levels of interleukin-6 and C-reactive protein in serum were indicative of dehydration at baseline, and that dehydration, high body mass index, reduced urine uromodulin, and increased serum interleukin-6, C-reactive protein, and lipopolysaccharide-binding protein at baseline were predictive of acute kidney injury on subsequent workdays. Our findings suggest a method for identifying agricultural workers at greatest risk for kidney injury and reveal potential mechanisms responsible for this process, including pathways overlapping in dehydration and kidney injury. These results will guide future studies confirming these mechanisms and introducing interventions to protect kidney health in this vulnerable population.
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Affiliation(s)
- Madelyn C Houser
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Valerie Mac
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Daniel J Smith
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Roxana C Chicas
- Renal Division, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Nezahualcoyotl Xiuhtecutli
- Farmworker Association of Florida, Apopka, FL, USA.,Department of Anthropology, Tulane University, New Orleans, LA, USA
| | - Joan D Flocks
- Social Policy Division, Center for Governmental Responsibility, Levin College of Law, University of Florida, Gainesville, FL, USA
| | - Lisa Elon
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | | | - Jeff M Sands
- Renal Division, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Vicki S Hertzberg
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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27
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Juett LA, James LJ, Mears SA. Effects of Exercise on Acute Kidney Injury Biomarkers and the Potential Influence of Fluid Intake. ANNALS OF NUTRITION AND METABOLISM 2021; 76 Suppl 1:53-59. [PMID: 33774615 DOI: 10.1159/000515022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 12/16/2020] [Indexed: 11/19/2022]
Abstract
Acute kidney injury (AKI) incidence (diagnosed by changes in serum creatinine [Cr]) following prolonged endurance events has been reported to be anywhere from 4 to 85%, and hypohydration may contribute to this. Whilst an increase in serum Cr indicates impaired kidney function, this might be influenced by muscle damage. Therefore, the use of other AKI biomarkers which can detect renal tubular injury may be more appropriate. The long-term consequences of AKI are not well understood, but there are some potential concerns of an increased subsequent risk of chronic kidney disease (CKD). Therefore, this brief review explores the effects of exercise training/competition on novel AKI biomarkers and the potential influence of fluid intake. The increase in novel AKI biomarkers following prolonged endurance events suggests renal tubular injury. This is likely due to the long duration and relatively high exercise intensity, producing increased sympathetic tone, body temperature, hypohydration, and muscle damage. Whilst muscle damage appears to be an important factor in the pathophysiology of exercise-associated AKI, it may require coexisting hypohydration. Fluid intake seems to play a role in exercise-associated AKI, as maintaining euhydration with water ingestion during simulated physical work in the heat appears to attenuate rises in AKI biomarkers. The composition of fluid intake may also be important, as high-fructose drinks have been shown to exacerbate AKI biomarkers. However, it is yet to be seen if these findings are applicable to athletes performing strenuous exercise in a temperate environment. Additionally, further work should examine the effects of repeated bouts of strenuous exercise on novel AKI biomarkers.
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Affiliation(s)
- Loris Allan Juett
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Stephen Andrew Mears
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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28
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Tominaga T, Ma S, Sugama K, Kanda K, Omae C, Choi W, Hashimoto S, Aoyama K, Yoshikai Y, Suzuki K. Changes in Urinary Biomarkers of Organ Damage, Inflammation, Oxidative Stress, and Bone Turnover Following a 3000-m Time Trial. Antioxidants (Basel) 2021; 10:antiox10010079. [PMID: 33435279 PMCID: PMC7826822 DOI: 10.3390/antiox10010079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/29/2020] [Accepted: 01/05/2021] [Indexed: 01/06/2023] Open
Abstract
Strenuous exercise induces organ damage, inflammation, and oxidative stress. Currently, to monitor or investigate physiological conditions, blood biomarkers are frequently used. However, blood sampling is perceived to be an invasive method and may induce stress. Therefore, it is necessary to establish a non-invasive assessment method that reflects physiological conditions. In the present study, we aimed to search for useful biomarkers of organ damage, inflammation, oxidative stress, and bone turnover in urine following exercise. Ten male runners participated in this study and performed a 3000-m time trial. We measured biomarkers in urine collected before and immediately after exercise. Renal damage markers such as urea protein, albumin, N-acetyl-β-D-glucosaminidase (NAG), and liver-fatty acid binding protein (L-FABP), and an intestinal damage marker, intestine-fatty acid binding protein (I-FABP), increased following exercise (p < 0.05). However, a muscle damage marker, titin N-terminal fragments, did not change (p > 0.05). Inflammation-related factors (IRFs), such as interleukin (IL)-1β, IL-1 receptor antagonist (IL-1ra), IL-6, complement (C) 5a, myeloperoxidase (MPO), calprotectin, monocyte chemoattractant protein (MCP)-1, and macrophage colony-stimulating factor (M-CSF), increased whereas IRFs such as IL-4 and IL-10 decreased following exercise (p < 0.05). IRFs such as tumor necrosis factor (TNF)-α, IL-2, IL-8, IL-12p40, and interferon (IFN)-γ did not change (p > 0.05). Oxidative stress markers, such as thiobarbituric acid reactive substances (TBARS) and nitrotyrosine, did not change following exercise (p > 0.05) whereas 8-hydroxy-2'-deoxyguanosine (8-OHdG) decreased (p < 0.05). Bone resorption markers, such as cross-linked N-telopeptide of type I collagen (NTX) and deoxypyridinoline (DPD), did not change following exercise (p > 0.05). These results suggest that organ damage markers and IRFs in urine have the potential to act as non-invasive indicators to evaluate the effects of exercise on organ functions.
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Affiliation(s)
- Takaki Tominaga
- Graduate School of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan; (C.O.); (W.C.)
- Research Fellow of Japan Society for the Promotion of Sciences, Tokyo 102-0083, Japan;
- Correspondence: (T.T.); (K.S.); Tel.: +81-4-2947-6753 (T.T.); +81-4-2947-6898 (K.S.)
| | - Sihui Ma
- Research Fellow of Japan Society for the Promotion of Sciences, Tokyo 102-0083, Japan;
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Kaoru Sugama
- Future Innovation Institute, Waseda University, Shinjuku 162-0041, Japan; (K.S.); (K.K.)
| | - Kazue Kanda
- Future Innovation Institute, Waseda University, Shinjuku 162-0041, Japan; (K.S.); (K.K.)
| | - Chiaki Omae
- Graduate School of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan; (C.O.); (W.C.)
| | - Wonjun Choi
- Graduate School of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan; (C.O.); (W.C.)
| | | | | | - Yasunobu Yoshikai
- Division of Host Defense, Medical Institute of Bioregulation, Kyushu University, Fukuoka 812-8582, Japan;
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
- Correspondence: (T.T.); (K.S.); Tel.: +81-4-2947-6753 (T.T.); +81-4-2947-6898 (K.S.)
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Wulkan RW, van der Horst M. Detection and correction of incomplete duplicate 24-hour urine collections - theory and practical evidence. Biochem Med (Zagreb) 2020; 31:010706. [PMID: 33380893 PMCID: PMC7745164 DOI: 10.11613/bm.2021.010706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/07/2020] [Indexed: 11/22/2022] Open
Abstract
Introduction The intraindividual variability in urinary creatinine excretion is notoriously large. The aims of this study were to investigate the variability of duplicate consecutive 24-hour urinary creatinine excretions in patients and to develop a model for the detection and correction of discrepant creatinine excretions. Materials and methods A group of 270 patients (82 men and 188 women) were included in the study. We collected the following data: urinary 24-hour volumes (volumetric/gravimetric) and urinary creatinine concentrations (Jaffé/enzymatic) on both collection days. We performed specific calculations to detect discrepant creatinine excretions. Results In 60 patients (22%) discrepant collections were found. Among the remaining 78%, 22% of the patients collected very accurately (almost identical urinary creatinine excretions). In this subgroup the volume ratios and the creatinine concentration ratios behave inversely as in a dilution curve. A theoretical model and six collection scenarios were developed to detect, interpret and correct discrepant collections. Practical examples are given to illustrate the use of the model in successful correction of creatinine and other analytes for under- or overcollection. Conclusions We conclude that missed or overcollected urine volumes are the largest source of variation in creatinine excretion. Discrepancies in consecutive duplicate 24-hour creatinine excretions can be detected and corrected with specific calculations by means of the presented model. The effectiveness of these corrections is demonstrated with examples from daily practice. These calculations can be easily automated.
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Affiliation(s)
- Raymond W Wulkan
- Clinical Chemistry Laboratory, Maasstad Hospital, Rotterdam, The Netherlands
| | - Martin van der Horst
- Clinical Chemistry Laboratory, Treant Health Care Group, Scheper Hospital Location, Emmen, The Netherlands
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Rojas-Valverde D, Timón R, Sánchez-Ureña B, Pino-Ortega J, Martínez-Guardado I, Olcina G. Potential Use of Wearable Sensors to Assess Cumulative Kidney Trauma in Endurance Off-Road Running. J Funct Morphol Kinesiol 2020; 5:jfmk5040093. [PMID: 33467308 PMCID: PMC7804864 DOI: 10.3390/jfmk5040093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/25/2022] Open
Abstract
(1) Background: This study aimed to explore wearable sensors' potential use to assess cumulative mechanical kidney trauma during endurance off-road running. (2) Methods: 18 participants (38.78 ± 10.38 years, 73.24 ± 12.6 kg, 172.17 ± 9.48 cm) ran 36 k off-road race wearing a Magnetic, Angular Rate and Gravity (MARG) sensor attached to their lower back. Impacts in g forces were recorded throughout the race using the MARG sensor. Two blood samples were collected immediately pre- and post-race: serum creatinine (sCr) and albumin (sALB). (3) Results: Sixteen impact variables were grouped using principal component analysis in four different principal components (PC) that explained 90% of the total variance. The 4th PC predicted 24% of the percentage of change (∆%) of sCr and the 3rd PC predicted the ∆% of sALB by 23%. There were pre- and post-race large changes in sCr and sALB (p ≤ 0.01) and 33% of participants met acute kidney injury diagnosis criteria. (4) Conclusions: The data related to impacts could better explain the cumulative mechanical kidney trauma during mountain running, opening a new range of possibilities using technology to better understand how the number and magnitude of the g-forces involved in off-road running could potentially affect kidney function.
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Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 86-3000, Costa Rica
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain; (R.T.); (I.M.-G.)
- Correspondence: (D.R.-V.); (G.O.); Tel.: +506-88250219 (D.R.-V.)
| | - Rafael Timón
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain; (R.T.); (I.M.-G.)
| | - Braulio Sánchez-Ureña
- Programa Ciencias del Ejercicio y la Salud (PROCESA), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 86-3000, Costa Rica;
| | - José Pino-Ortega
- Departmento de Actividad Física y Deporte, Facultad Ciencias del Deporte, 30720 Murcia, Spain;
| | - Ismael Martínez-Guardado
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain; (R.T.); (I.M.-G.)
| | - Guillermo Olcina
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain; (R.T.); (I.M.-G.)
- Correspondence: (D.R.-V.); (G.O.); Tel.: +506-88250219 (D.R.-V.)
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Rojas-Valverde D, Olcina G, Sánchez-Ureña B, Pino-Ortega J, Martínez-Guardado I, Timón R. Proteinuria and Bilirubinuria as Potential Risk Indicators of Acute Kidney Injury during Running in Outpatient Settings. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:medicina56110562. [PMID: 33120965 PMCID: PMC7692335 DOI: 10.3390/medicina56110562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023]
Abstract
Background and objectives: The purpose of this study was to explore which urinary markers could indicate acute kidney injury (AKI) during prolonged trail running in outpatient settings. Materials and Methods: Twenty-nine experienced trail runners (age 39.1 ± 8.8 years, weight 71.9 ± 11 kg, height 171.9 ± 8.3 cm) completed a 35 km event (cumulative positive ascend of 1815 m, altitude = 906 to 1178 m.a.s.l.) under a temperature of 25.52 ± 1.98 °C and humidity of 79.25 ± 7.45%). Two participant groups (AKI = 17 and No-AKI = 12) were made according to AKI diagnosis criteria based on pre- and post-race values of serum creatinine (sCr) (an increase of 1.5 times from baseline). Blood and urinalysis were performed immediately pre- and post-race. Results: Pre- vs. post-race differences in sCr and sBUN were found in both AKI and No-AKI groups (p < 0.01). Differences in post-race values were found between groups (p = 0.03). A total of 52% of AKI runners presented significant increases in proteinuria (χ2 = 0.94, p = 0.01) and 47% in bilirubinuria (χ2 = 0.94, p = 0.04). Conversely, No-AKI participants presented no significant increases in urine markers. Conclusions: These study’s findings may suggest the potential use of urinalysis as an accessible alternative in the outpatient setting to early identify transitional AKI until a clinical confirmation is performed.
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Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 86-3000, Costa Rica
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain;
- Correspondence: (D.R.-V.); (G.O.); (R.T.); Tel.: +506-8825-0219 (D.R.-V.)
| | - Guillermo Olcina
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain;
- Correspondence: (D.R.-V.); (G.O.); (R.T.); Tel.: +506-8825-0219 (D.R.-V.)
| | - Braulio Sánchez-Ureña
- Programa Ciencias del Ejercicio y la Salud (PROCESA), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 86-3000, Costa Rica;
| | - José Pino-Ortega
- Departmento de Actividad Física y Deporte, Facultad Ciencias del Deporte, 30720 Murcia, Spain;
| | - Ismael Martínez-Guardado
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain;
| | - Rafael Timón
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain;
- Correspondence: (D.R.-V.); (G.O.); (R.T.); Tel.: +506-8825-0219 (D.R.-V.)
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Chapman CL, Johnson BD, Parker MD, Hostler D, Pryor RR, Schlader Z. Kidney physiology and pathophysiology during heat stress and the modification by exercise, dehydration, heat acclimation and aging. Temperature (Austin) 2020; 8:108-159. [PMID: 33997113 PMCID: PMC8098077 DOI: 10.1080/23328940.2020.1826841] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
The kidneys' integrative responses to heat stress aid thermoregulation, cardiovascular control, and water and electrolyte regulation. Recent evidence suggests the kidneys are at increased risk of pathological events during heat stress, namely acute kidney injury (AKI), and that this risk is compounded by dehydration and exercise. This heat stress related AKI is believed to contribute to the epidemic of chronic kidney disease (CKD) occurring in occupational settings. It is estimated that AKI and CKD affect upwards of 45 million individuals in the global workforce. Water and electrolyte disturbances and AKI, both of which are representative of kidney-related pathology, are the two leading causes of hospitalizations during heat waves in older adults. Structural and physiological alterations in aging kidneys likely contribute to this increased risk. With this background, this comprehensive narrative review will provide the first aggregation of research into the integrative physiological response of the kidneys to heat stress. While the focus of this review is on the human kidneys, we will utilize both human and animal data to describe these responses to passive and exercise heat stress, and how they are altered with heat acclimation. Additionally, we will discuss recent studies that indicate an increased risk of AKI due to exercise in the heat. Lastly, we will introduce the emerging public health crisis of older adults during extreme heat events and how the aging kidneys may be more susceptible to injury during heat stress.
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Affiliation(s)
- Christopher L. Chapman
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Blair D. Johnson
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Mark D. Parker
- Department of Physiology and Biophysics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - David Hostler
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
| | - Riana R. Pryor
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
| | - Zachary Schlader
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, USA
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Wołyniec W, Ratkowski W, Renke J, Renke M. Changes in Novel AKI Biomarkers after Exercise. A Systematic Review. Int J Mol Sci 2020; 21:E5673. [PMID: 32784748 PMCID: PMC7461060 DOI: 10.3390/ijms21165673] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/26/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022] Open
Abstract
More than 100 substances have been identified as biomarkers of acute kidney injury. These markers can help to diagnose acute kidney injury (AKI) in its early phase, when the creatinine level is not increased. The two markers most frequently studied in plasma and serum are cystatin C and neutrophil gelatinase-associated lipocalin (NGAL). The former is a marker of kidney function and the latter is a marker of kidney damage. Some other promising serum markers, such as osteopontin and netrin-1, have also been proposed and studied. The list of promising urinary markers is much longer and includes cystatin C, NGAL, kidney injury molecule-1 (KIM-1), liver-type fatty-acid-binding protein (L-FABP), interleukin 18, insulin-like growth factor binding protein 7 (IGFBP-7), tissue inhibitor of metalloproteinases-2 (TIMP-2) and many others. Although these markers are increased in urine for no longer than a few hours after nephrotoxic agent action, they are not widely used in clinical practice. Only combined IGFBP-7/TIMP-2 measurement was approved in some countries as a marker of AKI. Several studies have shown that the levels of urinary AKI biomarkers are increased after physical exercise. This systematic review focuses on studies concerning changes in new AKI biomarkers in healthy adults after single exercise. Twenty-seven papers were identified and analyzed in this review. The interpretation of results from different studies was difficult because of the variety of study groups, designs and methodology. The most convincing data concern cystatin C. There is evidence that cystatin C is a better indicator of glomerular filtration rate (GFR) in athletes after exercise than creatinine and also at rest in athletes with a lean mass lower or higher than average. Serum and plasma NGAL are increased after prolonged exercise, but the level also depends on inflammation and hypoxia; therefore, it seems that in physical exercise, it is too sensitive for AKI diagnosis. It may, however, help to diagnose subclinical kidney injury, e.g., in rhabdomyolysis. Urinary biomarkers are increased after many types of exercise. Increases in NGAL, KIM-1, cystatin-C, L-FABP and interleukin 18 are common, but the levels of most urinary AKI biomarkers decrease rapidly after exercise. The importance of this short-term increase in AKI biomarkers after exercise is doubtful. It is not clear if it is a sign of mild kidney injury or physiological metabolic adaptation to exercise.
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Affiliation(s)
- Wojciech Wołyniec
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 9b Powstania Styczniowego Street, 81-519 Gdynia, Poland;
| | - Wojciech Ratkowski
- Department of Athletics, Gdańsk University of Physical Education and Sport, 1 Górskiego Street, 80-336 Gdańsk, Poland;
| | - Joanna Renke
- Department of General and Medical Biochemistry, University of Gdansk, 59 Wita Stwosza Street, 80-308 Gdańsk, Poland;
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 9b Powstania Styczniowego Street, 81-519 Gdynia, Poland;
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Sánchez-Cuesta A, Cortés-Rodríguez AB, Navas-Enamorado I, Lekue JA, Viar T, Axpe M, Navas P, López-Lluch G. High coenzyme Q10 plasma levels improve stress and damage markers in professional soccer players during competition. INT J VITAM NUTR RES 2020; 92:192-203. [PMID: 32639220 DOI: 10.1024/0300-9831/a000659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Ubiquinol, the reduced form of Coenzyme Q10 (CoQ10), is a key factor in bioenergetics and antioxidant protection. During competition, professional soccer players suffer from considerable physical stress causing high risk of muscle damage. For athletes, supplementation with several antioxidants, including CoQ10, is widely recommended to avoid oxidative stress and muscle damage. We performed an observational study of plasma parameters associated with CoQ10 levels in professional soccer players of the Spanish First League team Athletic Club de Bilbao over two consecutive seasons (n = 24-25) in order determine their relationship with damage, stress and performance during competition. We analyzed three different moments of the competition: preterm, initial phase and mid phase. Metabolites and factors related with stress (testosterone/cortisol) and muscle damage (creatine kinase) were determined. Physical activity during matches was analyzed over the 2015/16 season in those players participating in complete matches. In the mid phase of competition, CoQ10 levels were higher in 2015/16 (906.8 ± 307.9 vs. 584.3 ± 196.3 pmol/mL, p = 0.0006) High levels of CoQ10 in the hardest phase of competition were associated with a reduction in the levels of the muscle-damage marker creatine kinase (Pearsons' correlation coefficient (r) = - 0.460, p = 0.00168) and a trend for the stress marker cortisol (r = -0.252, p = 0.150). Plasma ubiquinol was also associated with better kidney function (r = -0.287, p = 0.0443 for uric acid). Furthermore, high CoQ10 levels were associated with higher muscle performance during matches. Our results suggest that high levels of plasma CoQ10 can prevent muscle damage, improve kidney function and are associated with higher performance in professional soccer players during competition.
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Affiliation(s)
- Ana Sánchez-Cuesta
- Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-JA, and CIBERER, Instituto de Salud Carlos III, Sevilla, Spain
| | - Ana Belén Cortés-Rodríguez
- Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-JA, and CIBERER, Instituto de Salud Carlos III, Sevilla, Spain
| | - Ignacio Navas-Enamorado
- Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-JA, and CIBERER, Instituto de Salud Carlos III, Sevilla, Spain
| | | | | | | | - Plácido Navas
- Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-JA, and CIBERER, Instituto de Salud Carlos III, Sevilla, Spain
| | - Guillermo López-Lluch
- Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-JA, and CIBERER, Instituto de Salud Carlos III, Sevilla, Spain
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Amaral LSDB, Souza CS, Lima HN, Soares TDJ. Influence of exercise training on diabetic kidney disease: A brief physiological approach. Exp Biol Med (Maywood) 2020; 245:1142-1154. [PMID: 32486850 PMCID: PMC7400720 DOI: 10.1177/1535370220928986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPACT STATEMENT Diabetic kidney disease (DKD) is associated with increased mortality in diabetic patients and has a negative impact on public health. The identification of potential therapies that help the management of DKD can contribute to the improvement of health and quality of life of patients. Thus, this paper is timely and relevant because, in addition to presenting a concise review of the pathogenesis and major pathophysiological mechanisms of DKD, it addresses the most recent findings on the impact of exercise training on this disease. Thus, since non-pharmacological interventions have gained increasing attention in the fight against chronic diseases, this paper appears as an important tool to increase knowledge and stimulate innovative research on the impact of exercise on kidney disease.
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Affiliation(s)
| | - Cláudia Silva Souza
- Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo 14049-900, Brazil
| | | | - Telma de Jesus Soares
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Bahia 45029-094, Brazil
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Al-Bouwarthan M, Quinn MM, Kriebel D, Wegman DH. Risk of Kidney Injury among Construction Workers Exposed to Heat Stress: A Longitudinal Study from Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113775. [PMID: 32466510 PMCID: PMC7312975 DOI: 10.3390/ijerph17113775] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/15/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
Saudi Arabia (SA) is one of the hottest countries in the world. This study was conducted to assess the impact of summer heat stress in Southeastern SA on short-term kidney injury (KI) among building construction workers and to identify relevant risk factors. Measurements of urinary albumin-creatinine ratio (ACR), height, weight, hydration, symptoms, daily work and behavioral factors were collected in June and September of 2016 from a cohort of construction workers (n = 65) in Al-Ahsa Province, SA. KI was defined as ACR ≥ 30 mg/g. Multivariate linear regression analysis was used to assess factors related to cross-summer changes in ACR. A significant increase in ACR occurred among most workers over the study period; incidence of KI was 18%. Risk factors associated with an increased ACR included dehydration, short sleep, and obesity. The findings suggest that exposure to summer heat may lead to the development of KI among construction workers in this region. Adequate hydration and promotion of healthy habits among workers may help reduce the risk of KI. A reduction in work hours may be the most effective intervention because this action can reduce heat exposure and improve sleep quality.
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Affiliation(s)
- Mohammed Al-Bouwarthan
- Department of Public Health, College of Health Sciences, University of Massachusetts Lowell, 61 Wilder Street, Lowell, MA 01854, USA; (M.M.Q.); (D.K.); (D.H.W.)
- Department of Environmental Health, College of Public Health, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
- Correspondence:
| | - Margaret M. Quinn
- Department of Public Health, College of Health Sciences, University of Massachusetts Lowell, 61 Wilder Street, Lowell, MA 01854, USA; (M.M.Q.); (D.K.); (D.H.W.)
| | - David Kriebel
- Department of Public Health, College of Health Sciences, University of Massachusetts Lowell, 61 Wilder Street, Lowell, MA 01854, USA; (M.M.Q.); (D.K.); (D.H.W.)
| | - David H. Wegman
- Department of Public Health, College of Health Sciences, University of Massachusetts Lowell, 61 Wilder Street, Lowell, MA 01854, USA; (M.M.Q.); (D.K.); (D.H.W.)
- La Isla Network, P.O. Box 816, Ada, MI 49301, USA
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Conte M, Martucci M, Mosconi G, Chiariello A, Cappuccilli M, Totti V, Santoro A, Franceschi C, Salvioli S. GDF15 Plasma Level Is Inversely Associated With Level of Physical Activity and Correlates With Markers of Inflammation and Muscle Weakness. Front Immunol 2020; 11:915. [PMID: 32477368 PMCID: PMC7235447 DOI: 10.3389/fimmu.2020.00915] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/20/2020] [Indexed: 01/10/2023] Open
Abstract
Growth differentiation factor 15 (GDF15) is a stress molecule produced in response to mitochondrial, metabolic and inflammatory stress with a number of beneficial effects on metabolism. However, at the level of skeletal muscle it is still unclear whether GDF15 is beneficial or detrimental. The aim of the study was to analyse the levels of circulating GDF15 in people of different age, characterized by different level of physical activity and to seek for correlation with hematological parameters related to inflammation. The plasma concentration of GDF15 was determined in a total of 228 subjects in the age range from 18 to 83 years. These subjects were recruited and divided into three different groups based on the level of physical activity: inactive patients with lower limb mobility impairment, active subjects represented by amateur endurance cyclists, and healthy controls taken from the general population. Cyclists were sampled before and after a strenuous physical bout (long distance cycling race). The plasma levels of GDF15 increase with age and are inversely associated with active lifestyle. In particular, at any age, circulating GDF15 is significantly higher in inactive patients and significantly lower in active people, such as cyclists before the race, with respect to control subjects. However, the strenuous physical exercise causes in cyclists a dramatic increase of GDF15 plasma levels, that after the race are similar to that of patients. Moreover, GDF15 plasma levels significantly correlate with quadriceps torque in patients and with the number of total leukocytes, neutrophils and lymphocytes in both cyclists (before and after race) and patients. Taken together, our data indicate that GDF15 is associated with decreased muscle performance and increased inflammation.
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Affiliation(s)
- Maria Conte
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Morena Martucci
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Giovanni Mosconi
- Nephrology and Dialysis, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - Antonio Chiariello
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Maria Cappuccilli
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Valentina Totti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Laboratory of Systems Medicine of Healthy Aging and Department of Applied Mathematics, Lobachevsky University, Nizhny Novgorod, Russia
| | - Stefano Salvioli
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
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Muñoz CX, Johnson EC, Kunces LJ, McKenzie AL, Wininger M, Butts CL, Caldwell A, Seal A, McDermott BP, Vingren J, Colburn AT, Wright SS, Lopez III V, Armstrong LE, Lee EC. Impact of Nutrient Intake on Hydration Biomarkers Following Exercise and Rehydration Using a Clustering-Based Approach. Nutrients 2020; 12:nu12051276. [PMID: 32365848 PMCID: PMC7282025 DOI: 10.3390/nu12051276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 12/26/2022] Open
Abstract
We investigated the impact of nutrient intake on hydration biomarkers in cyclists before and after a 161 km ride, including one hour after a 650 mL water bolus consumed post-ride. To control for multicollinearity, we chose a clustering-based, machine learning statistical approach. Five hydration biomarkers (urine color, urine specific gravity, plasma osmolality, plasma copeptin, and body mass change) were configured as raw- and percent change. Linear regressions were used to test for associations between hydration markers and eight predictor terms derived from 19 nutrients merged into a reduced-dimensionality dataset through serial k-means clustering. Most predictor groups showed significant association with at least one hydration biomarker: (1) Glycemic Load + Carbohydrates + Sodium, (2) Protein + Fat + Zinc, (3) Magnesium + Calcium, (4) Pinitol, (5) Caffeine, (6) Fiber + Betaine, and (7) Water; potassium + three polyols, and mannitol + sorbitol showed no significant associations with any hydration biomarker. All five hydration biomarkers were associated with at least one nutrient predictor in at least one configuration. We conclude that in a real-life scenario, some nutrients may serve as mediators of body water, and urine-specific hydration biomarkers may be more responsive to nutrient intake than measures derived from plasma or body mass.
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Affiliation(s)
- Colleen X. Muñoz
- Department of Health Sciences, University of Hartford, West Hartford, CT 06117, USA;
- Correspondence:
| | - Evan C. Johnson
- Division of Kinesiology & Health, University of Wyoming, Laramie, WY 82071, USA;
| | | | | | - Michael Wininger
- Department of Health Sciences, University of Hartford, West Hartford, CT 06117, USA;
- Yale School of Public Health, New Haven, CT 06511, USA
- Department of Veterans Affairs, West Haven, CT 06516, USA
| | - Cory L. Butts
- Department of Health Promotion & Human Performance Weber State University, University of Arkansas, Fayetteville, AR 72701, USA; (C.L.B.); (A.C.); (A.S.); (B.P.M.)
| | - Aaron Caldwell
- Department of Health Promotion & Human Performance Weber State University, University of Arkansas, Fayetteville, AR 72701, USA; (C.L.B.); (A.C.); (A.S.); (B.P.M.)
| | - Adam Seal
- Department of Health Promotion & Human Performance Weber State University, University of Arkansas, Fayetteville, AR 72701, USA; (C.L.B.); (A.C.); (A.S.); (B.P.M.)
- California Polytechnic State University, San Luis Obispo, CA 93407, USA
| | - Brendon P. McDermott
- Department of Health Promotion & Human Performance Weber State University, University of Arkansas, Fayetteville, AR 72701, USA; (C.L.B.); (A.C.); (A.S.); (B.P.M.)
| | - Jakob Vingren
- Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA;
| | - Abigail T. Colburn
- Department of Kinesiology, Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA; (A.T.C.); (S.S.W.); (L.E.A.); (E.C.L.)
| | - Skylar S. Wright
- Department of Kinesiology, Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA; (A.T.C.); (S.S.W.); (L.E.A.); (E.C.L.)
| | - Virgilio Lopez III
- Department of Kinesiology, Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA; (A.T.C.); (S.S.W.); (L.E.A.); (E.C.L.)
| | - Lawrence E. Armstrong
- Department of Kinesiology, Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA; (A.T.C.); (S.S.W.); (L.E.A.); (E.C.L.)
| | - Elaine C. Lee
- Department of Kinesiology, Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA; (A.T.C.); (S.S.W.); (L.E.A.); (E.C.L.)
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Huang WC, Tung YT, Wu MS, Liu MC, Lin TJ, Yang MT. Low-Osmolality Carbohydrate-Electrolyte Solution Ingestion Avoid Fluid Loss and Oxidative Stress After Exhaustive Endurance Exercise. Antioxidants (Basel) 2020; 9:antiox9040336. [PMID: 32326004 PMCID: PMC7222420 DOI: 10.3390/antiox9040336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 02/07/2023] Open
Abstract
Low-osmolality carbohydrate–electrolyte solution (LCS) ingestion can replace losses from exercise-induced dehydration, but the benefits of LCS ingestion strategy after exhaustive endurance exercise (EEE) remain unknown. The present study evaluated the effects of LCS ingestion on dehydration, oxidative stress, renal function, and aerobic capacity after EEE. In our study with its double-blind, crossover, counterbalanced design, 12 healthy male participants were asked to consume LCS (150 mL four times per hour) or placebo (water) 1 h before and 1 h after EEE. All participants completed a graded exercise test to exhaustion on a treadmill for the determination of maximal oxygen consumption (V˙O2max), applied to further intensity calibration, and then completed the EEE test. The average heart rate, maximal heart rate, running time to exhaustion, and peak oxygen uptake (VO2peak) were recorded during the exercise period. The participants’ body weight was recorded at different time points before and after the EEE to calculate the dehydration rate. Blood samples were drawn at baseline and before, immediately after, 1 h after, and 2 h after EEE to determine indicators of oxidative stress and renal function. The results indicated that the dehydration rates in participants with LCS ingestion at 15 min, 30 min, and 45 min after EEE were significantly lower than in participants with placebo ingestion (−1.86 ± 0.47% vs. −2.24 ± 0.72%; −1.78 ± 0.50% vs. −2.13 ± 0.74%; −1.54 ± 0.51% vs. −1.94 ± 0.72%, respectively; p < 0.05). In addition, the concentration of catalase in participants with LCS ingestion immediately after EEE was significantly higher than in participants with placebo ingestion (2046.21 ± 381.98 nmol/min/mL vs. 1820.37 ± 417.35 nmol/min/mL; p < 0.05). Moreover, the concentration of protein carbonyl in participants with LCS ingestion immediately after EEE was slightly lower than in participants with placebo ingestion (2.72 ± 0.31 nmol carbonyl/mg protein vs. 2.89 ± 0.43 nmol carbonyl/mg protein; p = 0.06). No differences were noted for other variables. Our findings conclude that LCS ingestion can effectively avoid fluid loss and oxidative stress after EEE. However, LCS ingestion had no benefits for renal function or aerobic capacity.
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Affiliation(s)
- Wen-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan;
| | - Yu-Tang Tung
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 11301, Taiwan;
| | - Mai-Szu Wu
- TMU Research Center of Urology and Kidney, Taipei Medicine University, Taipei 110301, Taiwan;
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110301, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Ming-Che Liu
- Department of Urology, Taipei Medical University Hospital, Taipei 110301, Taiwan;
- Clinical Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
- School of Dental Technology, College of oral Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Tsai-Jung Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan;
| | - Ming-Ta Yang
- Center for General Education, Taipei Medical University, Taipei 110301, Taiwan
- Correspondence: ; Tel.: +886-2-27361661 (ext. 2275)
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Rojas-Valverde D, Sánchez-Ureña B, Crowe J, Timón R, Olcina GJ. Exertional rhabdomyolysis and acute kidney injury in endurance sports: A systematic review. Eur J Sport Sci 2020; 21:261-274. [PMID: 32202487 DOI: 10.1080/17461391.2020.1746837] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The increase of wide-spread participation in endurance events in sports such as open water swimming, cycling, running and triathlons, has given rise to a concern about potential implications for renal function and kidney health. This study aimed to delve into the findings on exertional rhabdomyolysis (ER) and acute kidney injury (AKI) in endurance sports, emphasizing the diagnostic criteria used, physical and environmental contextual conditions in which ER and AKI are reported. Following PRISMA guidelines for systematic reviews and meta-analysis, topic related studies were searched digital sources (from 2009 to 2020). Studies with biomarkers of ER and AKI reported in endurance or ultra-endurance events were included. A total of 43 publications (sample = 813) were extracted, and 345 (43.5%) individuals were diagnosed with ER (creatinine kinase > 5000 UI/L) and 130 (16.39%) with ER + AKI (creatinine ≥ 1.88 mg/dL). Out of the total cases of ER + AKI, 96.92% were in ultra-endurance runners. There were inconsistences between studies in diagnosis criteria for ER and AKI, which represented a difficulty in the interpretation of the data. Increased levels of muscle and kidney injury immediately after endurance events were reported, but after 5.86 days these levels usually returned to baseline. There is a lack of knowledge around the potential of repeated ER and AKI predisposing to long-term chronic kidney disease. More accurate markers for subclinical and functional AKI diagnosis are needed in the analysis of kidney health after endurance events. ER and AKI are serious clinical problems with significant morbidity. Further research may be in order to help define future prevention strategies.
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Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica.,Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
| | - Braulio Sánchez-Ureña
- Programa de Ciencias del Ejercicio y la Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica
| | - Jennifer Crowe
- Instituto Regional de Estudios Toxicológicos, Universidad Nacional, Heredia, Costa Rica
| | - Rafael Timón
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
| | - Guillermo J Olcina
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
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CERIANI F, CHIAPPA L, CRESPI A, DEI S, CAPITANI M, SEVERINI R, D’AMATO M, CARTOCCI A, LAZZERI G, TROIANO G. Master athletes and "1001 miles", the longest and most extreme European randonnée. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 60:E428-E430. [PMID: 31967102 PMCID: PMC6953447 DOI: 10.15167/2421-4248/jpmh2019.60.4.1370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 08/21/2019] [Indexed: 11/25/2022]
Affiliation(s)
- F. CERIANI
- U.O. Chirurgia Multimedica Castellanza Varese, Italy
| | - L. CHIAPPA
- U.O. Cardiologia H. Desio (Monza-Brianza), Italy
| | - A. CRESPI
- Dietologia e Medicina dello Sport Centro Medico Sant’Anna Nerviano (Milano), Italy
| | - S. DEI
- Azienda USL Toscana Sud Est, Italy
| | | | | | | | | | | | - G. TROIANO
- University of Siena, Italy
- Correspondence: Gianmarco Troiano, University of Siena, via A. Moro 2, 53100 Siena, Italy - E-mail:
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42
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Rojas-Valverde D, Olcina G, Gutiérrez-Vargas R, Crowe J. Heat Strain, External Workload, and Chronic Kidney Disease in Tropical Settings: Are Endurance Athletes Exposed? Front Physiol 2019; 10:1403. [PMID: 31824329 PMCID: PMC6881241 DOI: 10.3389/fphys.2019.01403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/31/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica.,Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
| | - Guillermo Olcina
- Grupo en Avances en el Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
| | - Randall Gutiérrez-Vargas
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica
| | - Jennifer Crowe
- Instituto Regional de Estudios en Sustancias Tóxicas (IRET), Universidad Nacional, Heredia, Costa Rica
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43
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Dumas SJ, Meta E, Borri M, Goveia J, Rohlenova K, Conchinha NV, Falkenberg K, Teuwen LA, de Rooij L, Kalucka J, Chen R, Khan S, Taverna F, Lu W, Parys M, De Legher C, Vinckier S, Karakach TK, Schoonjans L, Lin L, Bolund L, Dewerchin M, Eelen G, Rabelink TJ, Li X, Luo Y, Carmeliet P. Single-Cell RNA Sequencing Reveals Renal Endothelium Heterogeneity and Metabolic Adaptation to Water Deprivation. J Am Soc Nephrol 2019; 31:118-138. [PMID: 31818909 DOI: 10.1681/asn.2019080832] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/01/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Renal endothelial cells from glomerular, cortical, and medullary kidney compartments are exposed to different microenvironmental conditions and support specific kidney processes. However, the heterogeneous phenotypes of these cells remain incompletely inventoried. Osmotic homeostasis is vitally important for regulating cell volume and function, and in mammals, osmotic equilibrium is regulated through the countercurrent system in the renal medulla, where water exchange through endothelium occurs against an osmotic pressure gradient. Dehydration exposes medullary renal endothelial cells to extreme hyperosmolarity, and how these cells adapt to and survive in this hypertonic milieu is unknown. METHODS We inventoried renal endothelial cell heterogeneity by single-cell RNA sequencing >40,000 mouse renal endothelial cells, and studied transcriptome changes during osmotic adaptation upon water deprivation. We validated our findings by immunostaining and functionally by targeting oxidative phosphorylation in a hyperosmolarity model in vitro and in dehydrated mice in vivo. RESULTS We identified 24 renal endothelial cell phenotypes (of which eight were novel), highlighting extensive heterogeneity of these cells between and within the cortex, glomeruli, and medulla. In response to dehydration and hypertonicity, medullary renal endothelial cells upregulated the expression of genes involved in the hypoxia response, glycolysis, and-surprisingly-oxidative phosphorylation. Endothelial cells increased oxygen consumption when exposed to hyperosmolarity, whereas blocking oxidative phosphorylation compromised endothelial cell viability during hyperosmotic stress and impaired urine concentration during dehydration. CONCLUSIONS This study provides a high-resolution atlas of the renal endothelium and highlights extensive renal endothelial cell phenotypic heterogeneity, as well as a previously unrecognized role of oxidative phosphorylation in the metabolic adaptation of medullary renal endothelial cells to water deprivation.
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Affiliation(s)
- Sébastien J Dumas
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Elda Meta
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Mila Borri
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Jermaine Goveia
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Katerina Rohlenova
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Nadine V Conchinha
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Kim Falkenberg
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Laure-Anne Teuwen
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Laura de Rooij
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Joanna Kalucka
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Rongyuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Shawez Khan
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Federico Taverna
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Weisi Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Magdalena Parys
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Carla De Legher
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Stefan Vinckier
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Tobias K Karakach
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Luc Schoonjans
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lin Lin
- Lars Bolund Institute of Regenerative Medicine, Beijing Genomics Institute (BGI)-Qingdao, BGI-Shenzhen, Qingdao, China.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Lars Bolund
- Lars Bolund Institute of Regenerative Medicine, Beijing Genomics Institute (BGI)-Qingdao, BGI-Shenzhen, Qingdao, China.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Mieke Dewerchin
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Guy Eelen
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium
| | - Ton J Rabelink
- Division of Nephrology, Department of Internal Medicine, The Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Xuri Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China;
| | - Yonglun Luo
- Lars Bolund Institute of Regenerative Medicine, Beijing Genomics Institute (BGI)-Qingdao, BGI-Shenzhen, Qingdao, China; .,Department of Biomedicine, Aarhus University, Aarhus, Denmark.,China National GeneBank, Beijing Genomics Institute (BGI)-Shenzhen, Shenzhen, China; and.,Qingdao-Europe Advanced Institute for Life Sciences, Beijing Genomics Institute (BGI)-Qingdao, Qingdao, China
| | - Peter Carmeliet
- Department of Oncology, Laboratory of Angiogenesis and Vascular Metabolism, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium; .,Laboratory of Angiogenesis and Vascular Metabolism, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Wołyniec W, Kasprowicz K, Giebułtowicz J, Korytowska N, Zorena K, Bartoszewicz M, Rita-Tkachenko P, Renke M, Ratkowski W. Changes in Water Soluble Uremic Toxins and Urinary Acute Kidney Injury Biomarkers After 10- and 100-km Runs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4153. [PMID: 31661892 PMCID: PMC6862582 DOI: 10.3390/ijerph16214153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 12/24/2022]
Abstract
Acute kidney injury (AKI) is described as a relatively common complication of exercise. In clinical practice the diagnosis of AKI is based on serum creatinine, the level of which is dependent not only on glomerular filtration rate but also on muscle mass and injury. Therefore, the diagnosis of AKI is overestimated after physical exercise. The aim of this study was to determine changes in uremic toxins: creatinine, urea, uric acid, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), trimethylamine N-oxide (TMAO) and urinary makers of AKI: albumin, neutrophil gelatinase-associated lipocalin (uNGAL), kidney injury molecule-1 and cystatin-C (uCyst-C) after long runs. Sixteen runners, mean age 36.7 ± 8.2 years, (2 women, 14 men) participating in 10- and 100-km races were studied. Blood and urine were taken before and after the races to assess markers of AKI. A statistically significant increase in creatinine, urea, uric acid, SDMA and all studied urinary AKI markers was observed. TMAO and ADMA levels did not change. The changes in studied markers seem to be a physiological reaction, because they were observed almost in every runner. The diagnosis of kidney failure after exercise is challenging. The most valuable novel markers which can help in post-exercise AKI diagnosis are uCyst-C and uNGAL.
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Affiliation(s)
- Wojciech Wołyniec
- Department of Occupational, Metabolic and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | - Katarzyna Kasprowicz
- Department of Biology, Ecology and Sports Medicine, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland.
| | - Joanna Giebułtowicz
- Department of Bioanalysis and Drug Analysis, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Natalia Korytowska
- Department of Bioanalysis and Drug Analysis, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Katarzyna Zorena
- Department of Biology Ecology and Sport Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | - Maria Bartoszewicz
- Department of Biology Ecology and Sport Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | | | - Marcin Renke
- Department of Occupational, Metabolic and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
| | - Wojciech Ratkowski
- Department of Athletics, Department of Athletics, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland.
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Rojas-Valverde D, Sánchez-Ureña B, Pino-Ortega J, Gómez-Carmona C, Gutiérrez-Vargas R, Timón R, Olcina G. External Workload Indicators of Muscle and Kidney Mechanical Injury in Endurance Trail Running. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3909. [PMID: 31618865 PMCID: PMC6843759 DOI: 10.3390/ijerph16203909] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/07/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022]
Abstract
Muscle and kidney injury in endurance athletes is worrying for health, and its relationship with physical external workload (eWL) needs to be explored. This study aimed to analyze which eWL indexes have more influence on muscle and kidney injury biomarkers. 20 well-trained trail runners (age = 38.95 ± 9.99 years) ran ~35.27 km (thermal-index = 23.2 ± 1.8 °C, cumulative-ascend = 1815 m) wearing inertial measurement units (IMU) in six different spots (malleolus peroneus [MPleft/MPright], vastus lateralis [VLleft/VLright], lumbar [L1-L3], thoracic [T2-T4]) for eWL measuring using a special suit. Muscle and kidney injury serum biomarkers (creatin-kinase [sCK], creatinine (sCr), ureic-nitrogen (sBUN), albumin [sALB]) were assessed pre-, -post0h and post24h. A principal component (PC) analysis was performed in each IMU spot to extract the main variables that could explain eWL variance. After extraction, PC factors were inputted in multiple regression analysis to explain biomarkers delta change percentage (Δ%). sCK, sCr, sBUN, sALB presented large differences (p < 0.05) between measurements (pre < post24h < post0h). PC's explained 77.5-86.5% of total eWL variance. sCK Δ% was predicted in 40 to 47% by L1-L3 and MPleft; sCr Δ% in 27% to 45% by L1-L3 and MPleft; and sBUN Δ% in 38%-40% by MPright and MPleft. These findings could lead to a better comprehension of how eWL (impacts, player load and approximated entropy) could predict acute kidney and muscle injury. These findings support the new hypothesis of mechanical kidney injury during trail running based on L1-L3 external workload data.
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Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia 86-3000, Costa Rica.
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad de Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain.
| | - Braulio Sánchez-Ureña
- Programa de Ciencias del Ejercicio y la Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia 86-3000, Costa Rica.
| | - José Pino-Ortega
- Departamento de Actividad Física y Deporte, Facultad de Ciencias del Deporte, Universidad de Murcia. San Javier, 30720 Murcia, Spain.
| | - Carlos Gómez-Carmona
- Grupo en Optimización del Entrenamiento y Rendimiento Deportivo (GOERD), Facultad de Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain.
| | - Randall Gutiérrez-Vargas
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia 86-3000, Costa Rica.
| | - Rafael Timón
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad de Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain.
| | - Guillermo Olcina
- Grupo Avances en Entrenamiento Deportivo y Acondicionamiento Físico (GAEDAF), Facultad de Ciencias del Deporte, Universidad de Extremadura, 10005 Cáceres, Spain.
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Schlader ZJ, Hostler D, Parker MD, Pryor RR, Lohr JW, Johnson BD, Chapman CL. The Potential for Renal Injury Elicited by Physical Work in the Heat. Nutrients 2019; 11:nu11092087. [PMID: 31487794 PMCID: PMC6769672 DOI: 10.3390/nu11092087] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023] Open
Abstract
An epidemic of chronic kidney disease (CKD) is occurring in laborers who undertake physical work in hot conditions. Rodent data indicate that heat exposure causes kidney injury, and when this injury is regularly repeated it can elicit CKD. Studies in humans demonstrate that a single bout of exercise in the heat increases biomarkers of acute kidney injury (AKI). Elevations in AKI biomarkers in this context likely reflect an increased susceptibility of the kidneys to AKI. Data largely derived from animal models indicate that the mechanism(s) by which exercise in the heat may increase the risk of AKI is multifactorial. For instance, heat-related reductions in renal blood flow may provoke heterogenous intrarenal blood flow. This can promote localized ischemia, hypoxemia and ATP depletion in renal tubular cells, which could be exacerbated by increased sodium reabsorption. Heightened fructokinase pathway activity likely exacerbates ATP depletion occurring secondary to intrarenal fructose production and hyperuricemia. Collectively, these responses can promote inflammation and oxidative stress, thereby increasing the risk of AKI. Equivalent mechanistic evidence in humans is lacking. Such an understanding could inform the development of countermeasures to safeguard the renal health of laborers who regularly engage in physical work in hot environments.
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Affiliation(s)
- Zachary J Schlader
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA.
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN 47405, USA.
| | - David Hostler
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Mark D Parker
- Department of Physiology and Biophysics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Riana R Pryor
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - James W Lohr
- Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Blair D Johnson
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Christopher L Chapman
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
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Min HK, Sung SA, Lee SY, Lee SW. Sub-morbid dehydration-associated glomerular hyperfiltration: An emerging reality? Kidney Res Clin Pract 2019; 38:196-204. [PMID: 30991770 PMCID: PMC6577221 DOI: 10.23876/j.krcp.18.0147] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/01/2019] [Accepted: 02/20/2019] [Indexed: 12/13/2022] Open
Abstract
Background Severe dehydration decreases renal perfusion. However, it is unclear whether sub-morbid dehydration affects kidney function similarly. Although there have been numerous animal and human studies that have suggested mild dehydration is associated with glomerular hyperfiltration, it has not been confirmed on a large-scale in the general population. Therefore, we aimed to identify the relationship between hydration status and kidney function. Methods We reviewed the data of 28,342 adults who participated in the Korea National Health and Nutrition Examination Surveys. Urine specific gravity unit (SGU) was the primary variable that indicated hydration status, and the estimated glomerular filtration rate (eGFR) was used as the primary outcome. Results Multivariate linear regression analysis showed urine SGU was positively associated with eGFR, which was J-shaped in the multivariate generalized additive model plot. In the penalized spline curve analysis, the odds ratio for high eGFR was steadily increased. Although increased urine SGU was associated with decreased blood pressure and pulse rate, it had no effect on increased fasting glucose and total cholesterol, suggesting conflicting cardio-metabolic dehydration effects. Conclusion Dehydration, presumably sub-morbid in an ambulatory community-dwelling general population, is associated with higher kidney function. The clinical significance of sub-morbid dehydration-associated glomerular hyperfiltration needs further investigation.
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Affiliation(s)
- Hyang Ki Min
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Korea
| | - Su Ah Sung
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Korea
| | - So Young Lee
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Korea
| | - Sung Woo Lee
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Korea
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Biochemical Markers of Renal Hypoperfusion, Hemoconcentration, and Proteinuria after Extreme Physical Exercise. ACTA ACUST UNITED AC 2019; 55:medicina55050154. [PMID: 31108972 PMCID: PMC6571854 DOI: 10.3390/medicina55050154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/18/2019] [Accepted: 05/15/2019] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Physical exercise increases the blood perfusion of muscles, but decreases the renal blood flow. There are several markers of renal hypoperfusion which are used in the differential diagnosis of acute kidney failure. Albuminuria is observed after almost any exercise. The aim of this study was to assess changes in renal hypoperfusion and albuminuria after a 100-km race. Materials and Methods: A total of 27 males who finished a 100-km run were studied. The mean age of the runners was 38.04 ± 5.64 years. The exclusion criteria were a history of kidney disease, glomerular filtration rate (GFR) <60 ml/min, and proteinuria. Blood and urine were collected before and after the race. The urinary albumin/creatinine ratio (ACR), fractional excretion of urea (FeUrea) and sodium (FeNa), plasma urea/creatinine ratio (sUrea/Cr), urine/plasma creatinine ratio (u/pCr), urinary sodium to potassium ratio (uNa/K), and urinary potassium to urinary potassium plus sodium ratio (uK/(K+Na)) were calculated. Results: After the race, significant changes in albuminuria and markers of renal hypoperfusion (FeNa, FeUrea, sUrea/Cr, u/sCr, urinary Na, uNa/K, uK/(K+Na)) were found. Fifteen runners (55.56%) had severe renal hypoperfusion (FeUrea <35, uNa/K <1, and uK/(Na+K) >0.5) after the race. The mean ACR increased from 6.28 ± 3.84 mg/g to 48.43 ± 51.64 mg/g (p < 0.001). The ACR was higher in the group with severe renal hypoperfusion (59.42 ± 59.86 vs. 34.68 ± 37.04 mg/g), but without statistical significance. Conclusions: More than 50% of the runners had severe renal hypoperfusion after extreme exercise. Changes in renal hemodynamics are probably an important, but not the only, factor of post-exercise proteinuria.
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Chapman CL, Johnson BD, Sackett JR, Parker MD, Schlader ZJ. Soft drink consumption during and following exercise in the heat elevates biomarkers of acute kidney injury. Am J Physiol Regul Integr Comp Physiol 2019; 316:R189-R198. [DOI: 10.1152/ajpregu.00351.2018] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to test the hypothesis that consuming a soft drink (i.e., a high-fructose, caffeinated beverage) during and following exercise in the heat elevates biomarkers of acute kidney injury (AKI) in humans. Twelve healthy adults drank 2 liters of an assigned beverage during 4 h of exercise in the heat [35.1 (0.1)°C, 61 (5)% relative humidity] in counterbalanced soft drink and water trials, and ≥1 liter of the same beverage after leaving the laboratory. Stage 1 AKI (i.e., increased serum creatinine ≥0.30 mg/dl) was detected at postexercise in 75% of participants in the Soft Drink trial compared with 8% in Water trial ( P = 0.02). Furthermore, urinary neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of AKI, was higher during an overnight collection period after the Soft Drink trial compared with Water in both absolute concentration [6 (4) ng/dl vs. 5 (4) ng/dl, P < 0.04] and after correcting for urine flow rate [6 (7) (ng/dl)/(ml/min) vs. 4 (4) (ng/dl)/(ml/min), P = 0.03]. Changes in serum uric acid from preexercise were greater in the Soft Drink trial than the Water trial at postexercise ( P < 0.01) and 24 h ( P = 0.05). There were greater increases from preexercise in serum copeptin, a stable marker of vasopressin, at postexercise in the Soft Drink trial ( P < 0.02) than the Water trial. These findings indicate that consuming a soft drink during and following exercise in the heat induces AKI, likely via vasopressin-mediated mechanisms.
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Affiliation(s)
- Christopher L. Chapman
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Blair D. Johnson
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - James R. Sackett
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Mark D. Parker
- Department of Physiology and Biophysics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Zachary J. Schlader
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
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