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Cited by 82Muscle and Compartmental DisordersElectrolyte and hormonal disordersThermoregulation and physiological responses

Rhabdomyolysis and Hyponatremia: A cluster of five cases at the 161-km 2009 Western States Endurance Run

Bruso, Jessica Rose, Hoffman, Martin D., Rogers, Ian R., Lee, Linda, Towle, Gary, Hew-Butler, Tamara·2010·Wilderness & Environmental Medicine
DOI 10.1016/j.wem.2010.06.012
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Abstract

OBJECTIVE: Five of 400 starters of the 2009 Western States Endurance Run (WSER) were hospitalized with hyponatremia and rhabdomyolysis. This article explores the risk factors associated with development of hyponatremia and rhabdomyolysis. METHODS: Data on the 5 cases were collected retrospectively from the runners and medical records, and all race participants were invited to complete a post-race survey. Characteristics of the cases were compared with the other race participants. RESULTS: The 5 runners developing hyponatremia with rhabdomyolysis were men with a mean (±SD) age of 39 ± 7 years. Presenting complaints included neurological symptoms among 3 and nausea among 3. Compared with those runners not developing hyponatremia with rhabdomyolysis, the cases tended to be younger, faster, more likely to have sustained an injury which interfered with training prior to the race, and were more likely to use nonsteroidal anti-inflammatory drugs (NSAIDs) during the race. The 3 of 5 cases progressing to acute renal failure were characterized by higher initial blood urea nitrogen (BUN; 43-69 vs 18-23 mg/dL) and creatinine (2.8-4.9 vs 1.1-1.2 mg/dL) levels but were not distinguished by creatinine phosphokinase (CPK) concentrations. CONCLUSIONS: Over 1% of participants in the 2009 WSER were hospitalized with hyponatremia in combination with rhabdomyolysis. These individuals tended to be younger, faster, more likely to have had an injury that interfered with training, and more likely to have used NSAIDs during the race. Higher initial BUN and creatinine levels, but not CPK concentrations, distinguished those 3 who progressed to acute renal failure.

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Authors
Bruso, J. R., Hoffman, M. D., Rogers, I. R., Lee, L., Towle, G., & Hew-Butler, T.
Affiliations
  • University of California Davis Medical Center (US)
  • VA Northern California Health Care System (US)
  • The University of Western Australia (AU)
  • Meadville Public Library (US)
  • Oswego Community Hospital (US)
  • Exercise Science, Oakland University, Rochester, MI, USA
Corresponding author
Hoffman, Martin D.
ORCID
Venue
Wilderness & Environmental Medicine
Publisher
SAGE Publications
Published
2010-12
Volume
21
Issue
4
Pages
303-308
ISSN
  • 1080-6032 (ISSN-L)
  • 1545-1534
DOI
10.1016/j.wem.2010.06.012
OpenAlex
W2099105641
Cited by
82
References
24
Citations by year
2026: 1 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 11 · 2018: 10 · 2017: 6 · 2016: 3 · 2015: 7 · 2014: 6 · 2013: 9 · 2012: 3
FWCI
5.06
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Wilderness and Environmental Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (University of Western Australia) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Muscle and Compartmental Disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
  • Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
Keywords
rhabdomyolysis, hyponatremia, endurance running, acute kidney injury, nonsteroidal anti-inflammatory drugs, risk factors, blood urea nitrogen, creatinine, creatine kinase, neurological symptoms
MeSH terms
Adult, Anti-Inflammatory Agents, Non-Steroidal, Athletic Injuries, Blood Urea Nitrogen, Body Weight, Creatine Kinase, Creatinine, Humans, Hyponatremia, Male, Middle Aged, Physical Endurance, Potassium, Retrospective Studies, Rhabdomyolysis, Risk Factors, Running, Sodium, Cohort Studies, Biomarkers, Case-Control Studies, Urinalysis, Acute Kidney Injury

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