Risk of acute kidney injury and hyponatremia in long-distance runners

Long-distance running has gathered some momentum among health-conscious participants. However, some studies have revealed association between long-distance running and development of acute kidney injury. Although the impact usually lasts only for a few days after the event, some participants have been admitted for severe acute kidney injury, the minority of which require dialysis treatment. The mechanisms underlying the injury may include dehydration, development of rhabdomyolysis, heat stroke and concomitant use of NSAIDS. Unfortunately, there is no long-term follow-up study to determine the long-term effect on kidney function. Acute hyponatremia may develop in a significant proportion of long-distance runners. Majority of them were asymptomatic but a few fatal cases which were supposedly due to cerebral oedema have been reported. Excessive intake of hypotonic drinks, excessive sweating and secretion of non-osmotic antidiuretic hormone have been postulated to be the causes of hyponatremia. This mini review will discuss the pathophysiology of the development of acute kidney injury and hyponatremia. It will also discuss the prevention and treatment of both conditions. Keywords: Long-Distance, Marathon, Kidney Injury, Hyponatremia, Rhabdomyolysis