Changes in Kidney Functions during Middle-distance Triathlon in Male Athletes

Abstract

Strenuous exercise induces proteinuria which is related to the intensity of exercise. However, renal responses to each type of exercise during a middle-distance triathlon have not been reported. The present study, carried out on 7 healthy athletes, investigated renal function at rest and after each exercise of a half-triathlon race. Blood and urine samples were collected at rest and after each specific event. Protein excretion and renal clearances were determined on each sample. Compared with resting values, albuminuria was increased by a factor of 30 (p<0.05) after swimming but did not differ from the resting value after cycling and running (p>0.05). Rates of β₂-microglobulin and retinol-binding protein excretion did not change throughout the triathlon (p>0.05). Glomerular filtration rate (expressed as creatinine clearance) remained stable after each exercise event, whereas tubular reabsorption rate (expressed as urea clearance) was reduced by 50, 40 and 65% after swimming, cycling and running, respectively, compared to pre-exercise values (p<0.05). Glomerular membrane permeability (expressed as albumin clearance) was significantly increased by the swimming event (13 times, p<0.05). These results suggest that middle-distance triathlon has a noticeable impact on the glomerular membrane permeability (albumin clearance) and elimination of protein waste (urea clearance) depending on exercise type.

Key words

middle-distance triathlon - proteinuria - kidney filtration - glomerular permeability - tubular reabsorption

• References

• 1 Altman DG. (ed.) Practical statistics for medical research. London, GB: Chapman & Hall/CRC; 1999
• 2 Bentley DJ, Millet GP, Vleck VE, McNaughton LR. Specific aspects of contemporary triathlon: implications for physiological analysis and performance. Sports Med 2002; 32: 345-359
• 3 Coruzzi P, Biggi A, Musiari L, Ravanetti C, Novarini A. Renal hemodynamics and natriuresis during water immersion in normal humans. Pflügers Arch 1986; 407: 638-642
• 4 Dallam GM, Jonas S, Miller TK. Medical considerations in triathlon competition; recommendations for triathlon organisers, competitors and coaches. Sports Med 2005; 35: 143-161
• 5 Deen WD, Bridges CR, Brenner BM. Biophysical basis of glomerular permselectivity. J Membr Biol 1983; 71: 1-10
• 6 Doumas BT, Watson WA, Briggs HG. Albumin standards and the measurement of serum albumin with bromocresol green. Clin Chim Acta 1971; 31: 87-96
• 7 Flynn FV, Platt HS. The origins of proteins excreted in tubular proteinuria. Clin Chim Acta 1968; 21: 377-399
• 8 Fowler J, Cohen L. Practical statistics for field biology. Chichester, GB: John Wiley & Sons; 1993
• 9 Gutmann I, Wahlefeld AW. L(+)-Lactate. Determination with lactate dehydrogenase and NAD. In: Bergmeyer, Hue. eds. Methods of Enzymatic Analysis. New York: Academic Press; 1974: 1464-1468
• 10 Harriss DJ, Atkinson G. Ethical standards in sports and exercise science research. Int J Sports Med 2013; 34: 1025-1028
• 11 Hiller WD. Dehydration and hyponatremia during triathlon. Med Sci Sports Exerc 1989; 21: S219-S221
• 12 Hoffmann MD, Stuempfle KJ, Fogard K, Hew-Butler T, Winger J, Weiss RH. Urine dipstick analysis for identification of runners susceptible to acute kidney injury following an ultramarathon. J Sports Sci 2013; 31: 20-31
• 13 Lepers R, Knechtle B, Staley PJ. Trends in triathlon performance: effects of sex and age. Sports Med 2013; 43: 851-863
• 14 Martinez JM, Laird R. Managing triathlon competition. Curr Sports Med Rep 2003; 2: 142-146
• 15 Masson PL, Campiaso CL, Collet-Cassart D, Magnusson CGM, Richards CB, Sindic CJM. Particule counting immunoassay (PACIA). In: Langone JE. (ed. The Methods in Enzymology. New York: Academic Press; 1981: 106-139
• 16 McKay E, Slater RJ. Studies of human proteinuria. II. Some characteristics of the gamma-globulins excreted in normal, exercise, postural, and nephrotic proteinuria. J Clin Invest 1962; 41: 1638-1652
• 17 Metzmann E. Protein quantitation of both branches of the heidelber curve by monitoring the kinetic of immunoprecipitation. Behring Inst Mitt 1985; 78: 167-175
• 18 Milet GP, Dréano P, Bentley DJ. Physiological characteristics of elite short- and long-distance triathletes. Eur J Appl Physiol 2003; 88: 427-430
• 19 Mogensen CE, Solling K. Studies on renal tubular protein reabsorption: partial and near complete inhibition by certain amin acids. Scand J Clin Lab Invest 1977; 37: 477-486
• 20 Petersen PA, Evrin PE, Berggard I. Differentiation of glomerular, tubular and normal proteinuria: determinations of urinary excretion of beta-2-microblobulin, albumin and total proteins. J Clin Invest 1969; 48: 1189-1198
• 21 Poortmans JR. Exercise and renal function. Sports Med 1984; 1: 125-153
• 22 Poortmans JR, Blommaert E, Baptista M, De Broe ME, Nouwen EJ. Evidence of differential renal dysfunctions during exercise in men. Eur J Appl Physiol 1997; 76: 88-91
• 23 Poortmans JR, Brauman H, Staroukine M, Verniory A, Decaestecker C, Leclercq R. Indirect evidence of glomerular/tubular mixed-type postexercise proteinuria in healthy humans. Am J Physiol 1988; 254: F277-F283
• 24 Poortmans JR, Engels MF, Sellier M, Leclercq R. Urine protein excretion and swimming events. Med Sci Sports Exerc 1991; 23: 831-835
• 25 Poortmans JR, Geudvert C, Schorokoff K, De Plaen P. Postexercise proteinuria in childhood and adolescence. Int J Sports Med 1996; 17: 448-451
• 26 Poortmans JR, Labilloy D. The influence of work intensity on postexercise proteinuria. Eur J Appl Physiol 1988; 57: 260-263
• 27 Poortmans JR, Mathieu N, De Plaen P. Influence of running different distances on renal glomerular and tubular impairment in humans. Eur J Appl Physiol 1996; 72: 522-527
• 28 Poortmans JR, Rampaer L, Wolfs JC. Renal protein excretion after exercise in man. Eur J Appl Physiol 1989; 58: 476-480
• 29 Poortmans JR, Vanderstraeten J. Kidney function during exercise in health and diseased humans. Sports Med 1994; 18: 419-437
• 30 Poortmans JR, Zambraski EJ. The Renal System. In: Tipton CM. (ed. History of Exercise Physiology. Champaign, USA: Human Kinetics; 2014: 507-524
• 31 Puggina EF, Machado DR, Tourinho Filho H, Barbanti VJ. Half-ironman induces changes in the kidney function of triathletes. An Acad Bras Cienc 2014; 86: 429-436
• 32 Rüst CA, Knechtle B, Knechtle P, Rosemann T. Higher prevalence of exercise-associated hyponatremia in triple iron ultra-triathletes than reported for ironman triathletes. Chinese J Physiol 2012; 55: 147-155
• 33 Sharwood K, Collins M, Goedecke J, Wilson G, Noakes TD. Weight changes, sodium levels, and performance in the South African Ironman Triathlon. Clin J Sport Med 2002; 12: 391-399
• 34 Sugama K, Suzuki K, Yoshitani K, Kometani T. Urinary excretion of cytokines versus their plasma levels after endurance exercise. Exerc Immunol Rev 2013; 19: 29-48
• 35 Thomas BDJ, Motley CP. Myoglobinemia and endurance exercise: a study of twenty-five participants in a triathlon competition. Am J Sports Med 1984; 12: 113-119
• 36 Van Beaumont W. Red cell volume with changes in plasma osmolarity during maximal exercise. J Appl Physiol 1973; 35: 47-50
• 37 Vega J, Gutiérrez M, Goecke H, Idiaquez J. Renal failure secondary to effort rhabdomyolysis: report of three cases. Rev Med Chili 2006; 134: 211-216
• 38 Yaguchi H, Ishigooka M, Hatami S, Kobayashi T, Kubota Y, Nakadt T, Mitobe K. The effect of triathlon on urinary excretion of enzymes and proteins. Int Urol Nephrol 1998; 30: 107-112
• 39 Yatzidis H. New colorimetric method for quantitative determination of protein in urine. Clin Chem 1977; 23: 811-812