Hypohydration Augments the Acute Increase in Urinary Biomarkers of Kidney Injury Following the 100-mile Western States Endurance Run.

Details

• Alternative Title:
  Journal of Applied Physiology (Bethesda, Md. : 1985), 2025, v. 139, no. 5: Hypohydration Augments the Acute Increase in Urinary Biomarkers of Kidney Injury Following the 100-mile Western States Endurance Run.
• Journal Article:
  Journal of Applied Physiology (Bethesda, Md. : 1985)
• Personal Author:
  Linder, Braxton A. ; Jeong, Soolim ; Stute, Nina L. ; El-Kurd, Omar B. ; Vondrasek, Joseph ; Pasternak, Andrew ; Bagley, James R. ; Watso, Joseph C. ; Schlader, Zachary J. ; Babcock, Matthew C. ; Grosicki, Gregory J. ; Robinson, Austin T.
• Description:
  Ultraendurance races may transiently increase acute kidney injury (AKI) risk, yet data on contributing factors are sparse. Therefore, we examined the acute effects of the Western States Endurance Run WSER (100 miles; 161 km) on urinary AKI biomarkers and kidney blood flow, while also assessing the influence of race pace and hydration status. Blood and urine samples were collected to assess urine specific gravity (USG), creatinine, and AKI risk nephrin, neutrophil gelatinase-associated lipocalin (NGAL), insulin-like growth factor binding protein 7 (IGFBP7), tissue inhibitor of metalloproteinase 2 (TIMP2), and IGFBP-7·TIMP-2. Renal blood velocity and conductance were measured via Doppler ultrasonography. Pre and post measures were obtained from 36 runners (29 males/7 females, age: 44 ± 9 yr, mean finish time: 25:45:55). Urinary AKI biomarkers increased postrace, with nephrin, IGFBP7, and IGFBP7·TIMP-2 remaining elevated after indexing to creatinine (
  
  s < 0.008). Hydration status declined, with only 8 of 35 runners remaining euhydrated postrace. Finishing euhydrated attenuated increases in urinary creatinine and creatinine-indexed IGFBP-7·TIMP-2 (
  
  s ≤ 0.006). Faster race pace correlated with increases in USG (rho, ρ = 0.338,
  
  = 0.048) and urinary creatinine (rho, ρ = 0.443,
  
  = 0.010), but not with creatinine-indexed AKI biomarkers (
  
  s ≥ 0.382). Kidney blood velocity and conductance were unchanged (
  
  s ≥ 0.186). Finishing hydrated appears to help mitigate the transient increase in kidney injury following an ultraendurance race.
  
  Urinary concentrations of several acute kidney injury (AKI) biomarkers increased after completing the 2023 Western States Endurance Run; however, there were no changes in renal blood flow in a subset of runners. When normalized to creatinine, several AKI biomarkers, including IGFBP7·TIMP2 (an FDA-approved biomarker of AKI), remained elevated. Notably, finishing the race euhydrated appeared to have a protective effect, mitigating increases in IGFBP7·TIMP2.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Male
  • Female
  • Biomarkers
  • Acute Kidney Injury
  • Adult
  • Running
  • Middle Aged
  • Physical Endurance
  • Tissue Inhibitor of Metalloproteinase-2
  More +
• Keywords:
  • Ultramarathon
  • Acute kidney injury
  • renal blood flow
  • hydration
  • performance
• Source:
  Journal of Applied Physiology (Bethesda, Md. : 1985), 2025, v. 139, no. 5
• DOI:
  https://doi.org/10.1152/japplphysiol.00289.2025
• ISSN:
  8750-7587 ; 1522-1601
• Pubmed ID:
  41115071
• Pubmed Central ID:
  PMC12765470
• Document Type:
  Text
• Funding:
  NA/Western States Endurance Run Foundation/ ; UL1 TR003096/TR/NCATS NIH HHSUnited States/ ; R01OH011528/DOE ; EHSS ; Office of Health and Safety (OHS)/ ; K01 HL147998/HL/NHLBI NIH HHSUnited States/ ; R01 OH011528/OH/NIOSH CDC HHSUnited States/ ; P30 DK097512/DK/NIDDK NIH HHSUnited States/ ; K01HL147998/HHS ; National Institutes of Health (NIH)/ ; K01HL164978/HHS ; National Institutes of Health (NIH)/ ; UL1TR003096/HHS ; National Institutes of Health (NIH)/ ; U54AG062319/HHS ; National Institutes of Health (NIH)/ ; R15HL165325/HHS ; National Institutes of Health (NIH)/ ; 23CDA1037938/American Heart Association (AHA)/ ; R15 HL165325/HL/NHLBI NIH HHSUnited States/ ; K01 HL160772/HL/NHLBI NIH HHSUnited States/ ; U54 AG062319/AG/NIA NIH HHSUnited States/ ; NA/Auburn University Presidential Graduate Research Fellowship/ ; K01 HL164978/HL/NHLBI NIH HHSUnited States/ ; K01HL160772/HHS ; National Institutes of Health (NIH)/
• Genre:
  Journal Article
• Pages in Document:
  1379-1391 (27 pdf pages)
• Volume:
  139
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/260995/cdc_260995_DS1.pdf
• File Type:
  [PDF - 1.71 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:e9831d1be680c43d864d9d3688e40fb45a47e4c7c00b859e2dd81a4ab6cd98b3d5c54c10cde3e1b6b115d84d52a99a0b1b38d7d78f6ad8819c8da3a3bb087a63