Transient oliguria with renal tubular dysfunction after a 90 km running race

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In the course of a 19-d study of renal function in five ultramarathon runners, before, during and after a 90 km race, one runner developed transient oliguria with renal tubular dysfunction and anuria during and immediately after the race. Other features of the renal failure were an 84-fold increase in urine β2-microglobulin excretion (from 0.19 to 16.0 μg·in−1) and a much smaller increase in urine total protein excretion (from 0.07 to 0.18 mg·min−1) during the post-race period. Post-race creatinine clearance remained below pre-race levels throughout the study, varying between 42.8 and 72.9 ml·min−1, in contrast to the post-race 49% increase in the remaining runners (from 138.1 ± 12.9 to 205.5 ± 59.9 ml·min−1). Osmolal clearance also remained low (0.31 to 0.98 ml·min−1) compared with the pre-race values (1.46 ± 0.02 ml·min−1), as did the urine flow rates (0.11 to 0.18 ml·min−1) compared with the pre-race values (0.34 ± 0.02 ml·min−1). This renal dysfunction persisted despite the patient receiving 2 1 of intravenous fluids immediately after the race and probably resulted from fluid restriction during the race. There was full recovery of renal function 1 yr later when the subject again ran the Comrades Marathon.

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