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Exercise-Associated Hyponatremia: 2017 Update
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Exercise-associated hyponatremia (EAH) was initially described in the 1980s in endurance athletes, and work done since then has conclusively identified that overdrinking beyond thirst and non-osmotic arginine vasopressin release are the most common etiologic factors. In recent years, EAH has been described in a broader variety of athletic events and also has been linked to the development of rhabdomyolysis. The potential role of volume and sodium depletion in a subset of athletes has also been described. This review focuses on the most recent literature in the field of EAH and summarizes key new findings in the epidemiology, pathophysiology, treatment, and prevention of this condition.
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“For example, poorly-managed ultra-marathon hydration and electrolyte strategies can result in exercise-associated hyponatremia (serum sodium <135 mmol·L− 1), which is a potentially fatal complication of long-distance racing [9].”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [9]
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Tan, D. W., Yap, S. H., Wang, M., Fan, P. W., Teo, Y. S., Krishnasamy, P., Krishna, L., Hew‐Butler, T., & LEE, J. K. W. (2016) · Sports Medicine - Open · doi:10.1186/s40798-016-0050-3 · Cited by 13
Self-citationAn unusual cause of exercise‐induced hyponatremia
Morton, A. (2007) · Emergency Medicine Australasia · doi:10.1111/j.1742-6723.2007.00994.x · Cited by 11
Evaluation of the local irritation potential of hypertonic saline–dextran (HSD) in mice and rabbits
Dubick, M. A., & Wade, C. E. (2004) · Journal of Applied Toxicology · doi:10.1002/jat.943 · Cited by 11
A Study of Serum Sodium Level Among Hong Kong Runners
Au-Yeung, K. L., Wu, W. C. V., Yau, W. H., & Ho, H. F. (2010) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0b013e3181f469f0 · Cited by 10
High Incidence of Hyponatremia in Rowers During a Four-week Training Camp
Mayer, C. U., Treff, G., Fenske, W. K., Blouin, K., Steinacker, J. M., & Allolio, B. (2015) · The American Journal of Medicine · doi:10.1016/j.amjmed.2015.04.014 · Cited by 9
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Urea Treatment for Exercise-associated Hyponatremia
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Flagged first, then by citations
Research works printed but not linked: 11
- 2008, Electrolyte Imbalance Blamed in Death of Football Player. Coroner’s Office Says Athlete Failed to Replenish Lost Sodium
- Blevins, 2014, Preps Sports Report
- Stevens, 2015, Update: Douglas County Football Player Has Died
- Baumgarder, 2009, Au Sable River Canoe Marathon Pushes Paddlers to the Limits
- Krabel, 2015, Athlete Dies after IM Frankfurt
- Vega, 2005, 8 Charged in Chico Hazing Death
- Sydney Morning Herald, 2012, Bushwalker Died from Drinking Too Much Water
- Gierer, 2016, Benning Soldier Dies after Falling Ill on First Day of Ranger School
- WIlber, 2005, District Officer Dies After Bike Ride. Over-hydration Cited as Factor
- Cruel, 2015, 12 Easy Ways to Drink More Water Every Day
- Associated Press, 2007, Woman Dies after Water Drinking Contest
Cited by
Sorted by citations
Tiller, N. B., Roberts, J. D., Beasley, L., Chapman, S., Pinto, J. M., Smith, L., Wiffin, M., Russell, M., Sparks, S. A., Duckworth, L., et al. (2019) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-019-0312-9 · Cited by 164
“Although the condition is rare, and individual susceptibility plays a role in prevalence, the earliest reported cases were observed in ultramarathon runners and Ironman triathletes [9] (i.”
BackgroundInfluentialWesseling, C., Glaser, J. R., Rodríguez-Guzmán, J., Weiss, I., Lucas, R. A. I., Peraza, S., da Silva, A. S., Hansson, E., Johnson, R. J., Hogstedt, C., et al. (2020) · Revista Panamericana de Salud Pública · doi:10.26633/rpsp.2020.15 · Cited by 150
Heffernan, S. M., Horner, K., De Vito, G., & Conway, G. E. (2019) · Nutrients · doi:10.3390/nu11030696 · Cited by 130
Yeargin, S. W., Dompier, T. P., Casa, D. J., Hirschhorn, R. M., & Kerr, Z. Y. (2019) · Journal of Athletic Training · doi:10.4085/1062-6050-504-17 · Cited by 61
Knechtle, B., Chlíbková, D., Papadopoulou, S. Κ., Mantzorou, M., Rosemann, T. J., & Nikolaidis, P. Τ. (2019) · Medicina · doi:10.3390/medicina55090537 · Cited by 64
Metadata
- Authors
- Hew-Butler, T., Loi, V., Pani, A., & Rosner, M. H.
- Affiliations
- Azienda Ospedaliera G. Brotzu (IT)
- University of Virginia Health System (US)
- Corresponding author
- Rosner, Mitchell H.
- Venue
- Frontiers in Medicine
- Publisher
- Frontiers Media SA
- Published
- 2017-03-03
- Volume
- 4
- Pages
- 21-21
- ISSN
- 2296-858X (ISSN-L)
- PMC
- PMC5334560
- OpenAlex
- W2594661228
- Cited by
- 112
- References
- 101
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 7 · 2023: 11 · 2022: 12 · 2021: 17 · 2020: 15 · 2019: 26 · 2018: 9
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion, other-oa)
- 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, endurance athletes, rhabdomyolysis, sodium depletion, hypovolemia, pathophysiology, prevention, treatment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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