Poortmans J R
Sports Med. 1984 Mar-Apr;1(2):125-53. doi: 10.2165/00007256-198401020-00003.
Exercise induces profound changes in the renal haemodynamics and in electrolyte and protein excretion. Effective renal plasma flow is reduced during exercise. The reduction is related to the intensity of exercise and renal blood flow may fall to 25% of the resting value when strenuous work is performed. The combination of sympathetic nervous activity and the release of catecholamine substances is involved in this process. The reduction of renal blood flow during exercise produces a concomitant effect on the glomerular filtration rate, though the latter decreases relatively less than the former during exertion. However, the degree of hydration has an important influence on the glomerular filtration rate. An antidiuretic effect is observed during intense exercise. Changes in urine flow are dependent on the plasma antidiuretic hormone levels which are increased by intense exercise. Heavy exercise has an inhibitory effect on most electrolytes (Na, Cl, Ca, P). With potassium, however, most studies report that potassium excretion is not consistently affected by moderate to heavy exercise. Increased aldosterone production helps the body to maintain sodium by increasing its reabsorption from the filtered tubular fluid. Recent studies suggest that sympathetic stimulation may be involved during exercise. Strenuous work leads to an increased excretion of erythrocytes and leucocytes in urine. Cylindruria has been regularly found in postexercise urine in different sports. Postexercise proteinuria is a common phenomenon in humans. It seems to be directly related to the intensity of exercise, rather than to its duration. This excretion of proteins in urine is a transient state with a half-time of approximately 1 hour. Postexercise proteinuria has a pattern different from normal physiological proteinuria. Immunochemical techniques demonstrate that postexercise proteinuria is of the mixed glomerular-tubular type, the former being predominant. The increased clearance of plasma proteins suggests an increased glomerular permeability and a partial inhibition of tubular reabsorption of macromolecules. Haemoglobinuria and myoglobinuria may be observed under special exercise conditions. The degree of hydration appears to be important to reduce these abnormalities.
运动可引起肾脏血流动力学以及电解质和蛋白质排泄的深刻变化。运动期间有效肾血浆流量减少。这种减少与运动强度有关，当进行剧烈运动时，肾血流量可能降至静息值的25%。交感神经活动和儿茶酚胺类物质的释放参与了这一过程。运动期间肾血流量的减少对肾小球滤过率产生相应影响，不过在运动期间后者的下降相对小于前者。然而，水合程度对肾小球滤过率有重要影响。剧烈运动时会观察到抗利尿作用。尿量变化取决于血浆抗利尿激素水平，剧烈运动可使其升高。剧烈运动对大多数电解质（钠、氯、钙、磷）有抑制作用。然而，对于钾而言，大多数研究报告称，中度至剧烈运动对钾排泄的影响并不一致。醛固酮分泌增加有助于身体通过增加从滤过的肾小管液中的重吸收来维持钠。最近的研究表明运动期间可能涉及交感神经刺激。剧烈运动导致尿中红细胞和白细胞排泄增加。在不同运动项目的运动后尿液中经常发现管型尿。运动后蛋白尿在人类中是一种常见现象。它似乎与运动强度直接相关，而非与运动持续时间有关。尿液中蛋白质的这种排泄是一种短暂状态，半衰期约为1小时。运动后蛋白尿的模式与正常生理性蛋白尿不同。免疫化学技术表明运动后蛋白尿属于肾小球 - 肾小管混合型，以肾小球型为主。血浆蛋白清除率增加表明肾小球通透性增加以及肾小管对大分子重吸收的部分抑制。在特殊运动条件下可能会观察到血红蛋白尿和肌红蛋白尿。水合程度对于减少这些异常情况似乎很重要。
