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Exertional Rhabdomyolysis and Acute Renal Failure in Marathon Runners

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Abstract

Strenuous exercise, including marathon running, can result in damage to skeletal muscle cells, a process known as exertional rhabdomyolysis. In most cases, this damage is resolved without consequence. However, when the damage is profound, there is a release of muscle proteins into the blood; one of these proteins, myoglobin, in high concentrations and under certain conditions (such as dehydration and heat stress) can precipitate in the kidneys, thereby resulting in acute renal failure. Although the marathon is a gruelling physiological challenge, with races sometimes run in hot and humid weather, acute renal failure is relatively infrequent. From case reports, a high proportion of marathon runners who developed acute renal failure had taken analgesics, had a viral or bacterial infection, or a pre-existing condition. The rare cases of acute renal failure in marathon runners may be a situation of the ‘perfect storm’ where there are several factors (heat stress, dehydration, latent myopathy, non-steroidal anti-inflammatory or other drug/analgesic use, and viral/bacterial infection) that, in some combination, come together to result in acute renal failure.

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References

  1. Clarkson PM, Hubal MJ. Exercise-induced muscle damage in humans. Am J Phys Med Rehabil 2002; 81: 552–69

    Article  Google Scholar 

  2. Clarkson PM, Kearns AK, Ronner P, et al. Serum creatine kinase levels and renal function measures in exertional muscle damage. Med Sci Sports Exerc 2006; 38: 623–7

    Article  PubMed  CAS  Google Scholar 

  3. Clarkson PM, Eichner ER. Exertional rhabdonryolysis: does elevated blood creatine kinase foretell renal failure? Curr Sports Med Rep 2006; 5: 57–60

    PubMed  Google Scholar 

  4. Seedat YK, Aboo N, Naicker S, et al. Acute renal failure in the “Comrades Marathon” runners. Ren Fail 1989; 11: 209–12

    Article  PubMed  Google Scholar 

  5. Schiff HB, MacSearraigh ET, Kallmeyer JC. Myoglobinmia, rhabdomyolysis and marathon running. Q J Med 1978; 47: 463–72

    PubMed  CAS  Google Scholar 

  6. MacSearraigh ET, Kallmeyer JC, Schiff HB. Acute renal failure in marathon runners. Nephron 1979; 24: 236–40

    Article  PubMed  CAS  Google Scholar 

  7. Vining KE, Nichols NJ, Seligson GR. Naproxen and acute renal failure in a runner [letter]. Ann Intern Med 1986; 105: 144

    Google Scholar 

  8. Lonka L, Pedersen RS. Fatal rhabdomyolysis in marathon runner. Lancet 1987; I: 857–8

    Article  Google Scholar 

  9. Boyd JF. Fatal rhabdomyolysis in a marathon runner. Lancet 1987; 1: 1089

    Article  PubMed  CAS  Google Scholar 

  10. Reid WA, McQueen A. Acute rhabdomyolysis in a marathon runner [letter]. Br J Sports Med 1987; 21: 49

    Article  PubMed  CAS  Google Scholar 

  11. Farquhar B, Kenney LW. Anti-inflammatory drugs, kidney function, and exercise. Sports Science Exchange 1997; 11: 1–5

    Google Scholar 

  12. Testa M, Navazio FM, Neugebauer J. Recognition, diagnosis, and treatment of mitochondrial myopattues in endurance athletes. Curr Sports Med Rep 2005; 4: 282–7

    PubMed  Google Scholar 

  13. Ratliff NB, Harris KM, Smith SA, et al. Cardiac arrest in a young marathon runner. Lancet 2002; 360: 542

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Priscilla M. Clarkson is a consultant to the Gatorade Sports Science Institute and a contracted researcher for Quaker and Medinova.

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Correspondence to Priscilla M. Clarkson.

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Clarkson, P.M. Exertional Rhabdomyolysis and Acute Renal Failure in Marathon Runners. Sports Med 37, 361–363 (2007). https://doi.org/10.2165/00007256-200737040-00022

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