Comrades Marathon, SCottsville, KwaZulu-Natal, South Africa.
S Afr Med J. 2011 Nov 28;101(12):876-8.
To evaluate common factors associated in the development of acute renal failure (ARF) in Comrades Marathon runners.
This was a retrospective case series of 4 runners hospitalised post-race with ARF in the 89 km 2010 Comrades Marathon. The outcome measures were incidence of analgesic use, levels of creatine phosphokinase (CPK) and degree of electrolyte supplementation (sodium, potassium, calcium and magnesium).
The incidence of ARF was 1/4 125 runners. They presented with rhabdomyolysis (mean admission CPK of 36 294 IU) and hyponatraemia (mean admission blood sodium level of 133 mEq/l). All had ingested an analgesic during the run (3 ingested a non-steroidal anti-inflammatory drug) and the same readily available anti-cramp electrolyte supplement. The average amount of supplemental sodium (452 mg), potassium (393 mg), calcium (330 mg) and magnesium (154 mg) ingested via this particular electrolyte supplement before and during the run did not exceed the recommended upper limits of daily intake. Three of the runners were Comrades Marathon novices.
There is a continuing need to clarify the specific cluster variants that cause ARF in Comrades Marathon runners, as the risk factors appear to have evolved since the first case described over 40 years ago.
评估与同志马拉松跑步者急性肾衰竭（ARF）发展相关的常见因素。
这是对 2010 年同志马拉松比赛后因 ARF 住院的 4 名跑步者进行的回顾性病例系列研究。结局指标为镇痛药使用情况、肌酸磷酸激酶（CPK）水平和电解质补充程度（钠、钾、钙和镁）。
ARF 的发生率为 1/4125 名跑步者。他们表现出横纹肌溶解症（入院时平均 CPK 为 36294IU）和低钠血症（入院时平均血钠水平为 133mEq/L）。所有患者在跑步过程中都服用了镇痛药（3 人服用了非甾体抗炎药），并服用了相同的现成抗痉挛电解质补充剂。通过该特定电解质补充剂在跑步前和跑步期间摄入的钠（452mg）、钾（393mg）、钙（330mg）和镁（154mg）的平均量未超过每日摄入量的上限。其中 3 名跑步者为同志马拉松新手。
需要继续阐明导致同志马拉松跑步者 ARF 的特定聚类变体，因为自 40 多年前首次描述以来，危险因素似乎已经发生了变化。
