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Cited by 205Electrolyte and hormonal disordersThermoregulation and physiological responsesExercise and Physiological Responses

The DOI matches its Crossref record; 168 of the 168 references it cites were found in a registry or an index.

Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015

Hew-Butler, Tamara, Rosner, Mitchell H., Fowkes-Godek, Sandra, Dugas, Jonathan P., Hoffman, Martin D., Lewis, Douglas P., Maughan, Ronald J., Miller, Kevin C., Montain, Scott J., Rehrer, Nancy J., Roberts, William O., Rogers, Ian R., Siegel, Arthur J., Stuempfle, Kristin J., Winger, James M., Verbalis, Joseph G.·2015·Clinical Journal of Sport Medicine
DOI 10.1097/jsm.0000000000000221
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Abstract

INTRODUCTION The third International Exercise-Associated Hyponatremia (EAH) Consensus Development Conference convened in Carlsbad, California in February 2015 with a panel of 17 international experts. The delegates represented 4 countries and 9 medical and scientific sub-specialties pertaining to athletic training, exercise physiology, sports medicine, water/sodium metabolism, and body fluid homeostasis. The primary goal of the panel was to review the existing data on EAH and update the 2008 Consensus Statement.1 This document serves to replace the second International EAH Consensus Development Conference Statement and launch an educational campaign designed to address the morbidity and mortality associated with a preventable and treatable fluid imbalance. The following statement is a summary of the data synthesized by the 2015 EAH Consensus Panel and represents an evolution of the most current knowledge on EAH. This document will summarize the most current information on the prevalence, etiology, diagnosis, treatment and prevention of EAH for medical personnel, athletes, athletic trainers, and the greater public. The EAH Consensus Panel strove to clearly articulate what we agreed upon, did not agree upon, and did not know, including minority viewpoints that were supported by clinical experience and experimental data. Further updates will be necessary to both: (1) remain current with our understanding and (2) critically assess the effectiveness of our present recommendations. Suggestions for future research and educational strategies to reduce the incidence and prevalence of EAH are provided at the end of the document as well as areas of controversy that remain in this topic. CONSENSUS METHODOLOGY The third International Exercise-Associated Hyponatremia Consensus Development Conference utilized National Institutes of Health guidelines, amended for a more holistic approach to fit the needs of both the group and the topic. Twenty-two individuals (17 accepted) were invited to participate in the consensus conference who: (1) have made scientific and/or clinical contributions to the topic of water and sodium homeostasis and/or hyponatremia and (2) represented a specific group (eg, nephrology, endurance medicine, etc.) or had unique topical expertise (eg, cystic fibrosis, muscle cramps, fluid balance, etc.). The present document is intended to serve as the scientific record of the conference with intent to widely disseminate this information to achieve maximum impact on both current health care practice and future medical research. The methodology governing the conduct of this consensus development conference is summarized below: A broad based expert panel was assembled. Panel members included researchers and clinicians in endocrinology (J.G.V.), nephrology (M.H.R.), emergency medicine (I.R.R.), family medicine (W.O.R., J.M.W., D.P.L.), internal medicine (A.J.S.), physical medicine and rehabilitation (M.D.H.), sports medicine (W.O.R., J.M.W., D.P.L.), athletic training (S.F.-G., K.C.M.) and exercise physiology (J.P.D., S.F.-G., T.H.-B., M.D.H., R.J.M., S.J.M., N.J.R., K.J.S.). These experts presented data on EAH in a day long public session, followed by open question/answer and discussion periods with the audience. The panel members met the following day in a closed session to prepare the consensus statement. Workgroups were created 3 months prior to the February 2015 meeting to update the following EAH target areas: epidemiology, etiology and pathophysiology, diagnosis, treatment, and prevention. Each workgroup was asked to present updated drafts for discussion during the closed session. A systematic, comprehensive and updated literature review was shared by the panel members prior to the February 2015 meeting, using a cloud storage service that was organized into workgroup categories (epidemiology, etiology and pathophysiology, diagnosis, treatment and prevention). All panel members had unlimited access to the cloud storage service and could add digital versions of published manuscripts to the EAH manuscript section at any time. The panel chairperson (MHR) was responsible for monitoring the progress of each work group, directing the closed session and guiding the panel's deliberations. Using the previous 2 EAH consensus statements as a starting point, each work-group was asked to: (1) incorporate new data into each assigned section and (2) update any outdated information. All recommendations were graded based on clinical strength, using the grading scale described by the American College of Chest Physicians (Table 1).2 Particular emphasis was placed on creating more generalized recommendations so as to prevent and treat EAH across a wider variety of athletic events, rather than the endurance sports focus of the 2 prior EAH Consensus Statements.TABLE 1: American College of Chest Physicians Classification Scheme for Grading Evidence and Recommendations Utilized in This Statement2Sponsorship The travel (except R.J

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  1. Hato, 2010, Diagnostic value of urine sodium concentration in hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion versus hypovolemia., Hawaii Med J, 69, 264
  2. Rogers, 2011, An intervention study of oral versus intravenous hypertonic saline administration in runners with exercise-associated hyponatremia. Clin., J Sport Med, 21, 200
  3. Stricker, 1988, Hormones and behavior., Am Sci, 76, 261

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Authors
Hew-Butler, T., Rosner, M. H., Fowkes-Godek, S., Dugas, J. P., Hoffman, M. D., Lewis, D. P., Maughan, R. J., Miller, K. C., Montain, S. J., Rehrer, N. J., Roberts, W. O., Rogers, I. R., Siegel, A. J., Stuempfle, K. J., Winger, J. M., & Verbalis, J. G.
Affiliations
  • University of Virginia Health System (US)
  • VA Northern California Health Care System (US)
  • Ascension Via Christi (US)
  • Loughborough University (GB)
  • Central Michigan University (US)
  • U.S. Army Research Institute of Environmental Medicine (US)
  • University of Otago (NZ)
  • University of Minnesota (US)
  • St John of God Murdoch Hospital (AU)
  • Harvard University (US)
  • Gettysburg College (US)
  • West Chester University (US)
  • Georgetown University Medical Center (US)
Corresponding author
  • Maughan, Ronald J.
  • Siegel, Arthur J.
ORCID
Venue
Clinical Journal of Sport Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-07
Volume
25
Issue
4
Pages
303-320
ISSN
1050-642X (ISSN-L)
DOI
10.1097/jsm.0000000000000221
OpenAlex
W2175165242
Cited by
205
References
168
Citations by year
2026: 16 · 2025: 11 · 2024: 7 · 2023: 13 · 2022: 13 · 2021: 21 · 2020: 16 · 2019: 30 · 2018: 24 · 2017: 19 · 2016: 26 · 2015: 8
FWCI
20.33
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Journal of Sport Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • The Cupola: Scholarship at Gettysburg College (Gettysburg College) (submittedVersion)
Topics
  • Health Sciences › Medicine › Nephrology › Electrolyte and hormonal disorders
  • Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
  • Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
Keywords
exercise-associated hyponatremia, fluid balance, hyponatremia treatment, hyponatremia diagnosis, sports training, endurance exercise, sports medicine, fluid homeostasis, consensus statement, cystic fibrosis, muscle cramps
MeSH terms
California, Drinking Behavior, Humans, Hyponatremia, Hypotonic Solutions, Exercise, Information Dissemination, Asymptomatic Diseases

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