Department of Occupational, Metabolic and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland.
Department of Biology, Ecology and Sports Medicine, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland.
Int J Environ Res Public Health. 2019 Oct 28;16(21):4153. doi: 10.3390/ijerph16214153.
Acute kidney injury (AKI) is described as a relatively common complication of exercise. In clinical practice the diagnosis of AKI is based on serum creatinine, the level of which is dependent not only on glomerular filtration rate but also on muscle mass and injury. Therefore, the diagnosis of AKI is overestimated after physical exercise. The aim of this study was to determine changes in uremic toxins: creatinine, urea, uric acid, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), trimethylamine N-oxide (TMAO) and urinary makers of AKI: albumin, neutrophil gelatinase-associated lipocalin (uNGAL), kidney injury molecule-1 and cystatin-C (uCyst-C) after long runs. Sixteen runners, mean age 36.7 ± 8.2 years, (2 women, 14 men) participating in 10- and 100-km races were studied. Blood and urine were taken before and after the races to assess markers of AKI. A statistically significant increase in creatinine, urea, uric acid, SDMA and all studied urinary AKI markers was observed. TMAO and ADMA levels did not change. The changes in studied markers seem to be a physiological reaction, because they were observed almost in every runner. The diagnosis of kidney failure after exercise is challenging. The most valuable novel markers which can help in post-exercise AKI diagnosis are uCyst-C and uNGAL.
急性肾损伤 (AKI) 被描述为运动的一种相对常见的并发症。在临床实践中，AKI 的诊断基于血清肌酐，其水平不仅取决于肾小球滤过率，还取决于肌肉量和损伤。因此，运动后 AKI 的诊断被高估了。本研究的目的是确定尿毒症毒素：肌酐、尿素、尿酸、不对称二甲基精氨酸 (ADMA)、对称二甲基精氨酸 (SDMA)、三甲基胺 N-氧化物 (TMAO) 和 AKI 的尿标志物：白蛋白、中性粒细胞明胶酶相关脂质运载蛋白 (uNGAL)、肾损伤分子-1 和胱抑素-C (uCyst-C) 在长跑后的变化。研究了 16 名跑步者，平均年龄 36.7 ± 8.2 岁（2 名女性，14 名男性），参加了 10 公里和 100 公里比赛。在比赛前后采集血液和尿液以评估 AKI 标志物。观察到肌酐、尿素、尿酸、SDMA 和所有研究的尿 AKI 标志物的水平显著升高。TMAO 和 ADMA 水平没有变化。研究标志物的变化似乎是一种生理反应，因为几乎每个跑步者都观察到了这些变化。运动后肾衰竭的诊断具有挑战性。最有价值的新标志物，如 uCyst-C 和 uNGAL，可帮助诊断运动后 AKI。
