1. Variation in renal responses to exercise in the heat with progressive acclimatisation.
- Author
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Omassoli J, Hill NE, Woods DR, Delves SK, Fallowfield JL, Brett SJ, Wilson D, Corbett RW, Allsopp AJ, and Stacey MJ
- Subjects
- Acute Kidney Injury physiopathology, Adult, Biomarkers blood, Creatinine blood, Glomerular Filtration Rate, Glycopeptides blood, Humans, Hydrocortisone blood, Interleukin-6 blood, Kidney physiopathology, Male, Military Personnel, Normetanephrine blood, Prospective Studies, Stress, Physiological, Young Adult, Acclimatization, Acute Kidney Injury diagnosis, Exercise, Hot Temperature, Kidney physiology
- Abstract
Objectives: To investigate changes in renal status from exercise in the heat with acclimatisation and to evaluate surrogates markers of Acute Kidney Injury., Design: Prospective observational cohort study., Methods: 20 male volunteers performed 60 min standardised exercise in the heat, at baseline and on four subsequent occasions during a 23-day acclimatisation regimen. Blood was sampled before and after exercise for serum creatinine, copeptin, interleukin-6, normetanephrine and cortisol. Fractional excretion of sodium was calculated for corresponding urine samples. Ratings of Perceived Exertion were reported every 5 min during exercise. Acute Kidney Injury was defined as serum creatinine rise ≥26.5 μmol L
-1 or fall in estimated glomerular filtration rate >25%. Predictive values of each candidate marker for developing Acute Kidney Injury were determined by ROC analysis., Results: From baseline to Day 23, serum creatinine did not vary at rest, but showed a significant (P<0.05) reduction post-exercise (120 [102, 139] versus 102 [91, 112] μmol L-1 ). Acute Kidney Injury was common (26/100 exposures) and occurred most frequently in the unacclimatised state. Log-normalised fractional excretion of sodium showed a significant interaction (exercise by acclimatization day), with post-exercise values tending to rise with acclimatisation. Ratings of Perceived Exertion predicted AKI (AUC 0.76, 95% confidence interval 0.65-0.88), performing at least as well as biochemical markers., Conclusions: Heat acclimatization is associated with reduced markers of renal stress and AKI incidence, perhaps due to improved regional perfusion. Acclimatisation and monitoring Ratings of Perceived Exertion are practical, non-invasive measures that could help to reduce renal injury from exercise in the heat., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)- Published
- 2019
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