title: Prevalence of hyponatremia, renal dysfunction, and other electrolyte abnormalities among runners before and after completing a marathon or half marathon.
abstract: BACKGROUND
  Prior reports on metabolic derangements observed in distance running frequently have small sample sizes, lack prerace laboratory measures, and report sodium as the sole measure.
  
  
  OBJECTIVE
  Metabolic abnormalities-hyponatremia, hypokalemia, renal dysfunction, hemoconcentration-are frequent after completing a full or half marathon. Clinically significant changes occur in these laboratory values after race completion.
  
  
  METHODS
  Observational, cross-sectional study.
  
  
  METHODS
  Consenting marathon and half marathon racers completed a survey as well as finger stick blood sampling on race day of the National Marathon to Fight Breast Cancer (Jacksonville, Florida, February 2008). Parallel blood measures were obtained before and after race completion (prerace, n = 161; postrace, n = 195).
  
  
  RESULTS
  The prevalence of prerace and postrace hyponatremia was 8 of 161 (5.0%) and 16 of 195 (8.2%), respectively. Hypokalemia was not present prerace but was present in 1 runner postrace (1 of 195). Renal dysfunction occurred prerace in 14 of 161 (8.7%) and postrace in 83 of 195 (42.6%). Among those with postrace renal dysfunction, 45.8% (38 of 83) were classified as moderate or severe. Hemoconcentration was present in 2 of 161 (1.2%) prerace and 6 of 195 (3.1%) postrace. The mean changes in laboratory values were (postrace minus prerace): sodium, 1.6 mmol/L; potassium, -0.2 mmol/L; blood urea nitrogen, 2.8 mg/dL; creatinine, 0.2 mg/dL; and hemoglobin, 0.3 g/dL for 149 pairs (except blood urea nitrogen, n = 147 pairs). Changes were significant for all comparisons (P < 0.01) except potassium (P = 0.08) and hemoglobin (P = 0.01).
  
  
  CONCLUSIONS
  Metabolic abnormalities are common among endurance racers, and they may be present prerace, including hyponatremia. The clinical significance of these findings is unknown.
  
  
  CONCLUSIONS
  It is unclear which runners are at risk for developing clinically important metabolic derangements. Participating in prolonged endurance exercise appears to be safe in the majority of racers.
authors.affiliation: Mayo Clinic, Jacksonville, Florida.
authors.forename: Michael
authors.initials: M
authors.lastname: Mohseni
authors.forename: Scott
authors.initials: S
authors.lastname: Silvers
authors.forename: Rebecca
authors.initials: R
authors.lastname: McNeil
authors.forename: Nancy
authors.initials: N
authors.lastname: Diehl
authors.forename: Tyler
authors.initials: T
authors.lastname: Vadeboncoeur
authors.forename: Walt
authors.initials: W
authors.lastname: Taylor
authors.forename: Shane
authors.initials: S
authors.lastname: Shapiro
authors.forename: Jennifer
authors.initials: J
authors.lastname: Roth
authors.forename: Sherry
authors.initials: S
authors.lastname: Mahoney