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Original article
peer-reviewed

Biochemistry in Endeavor Adventure Racers Study (BEARS)



Abstract

Background: Adventure sports events consist of a combination of two or more endurance disciplines, such as orienteering, running, and rock climbing, that range from a day’s to a week’s duration. No studies have examined acute kidney injury (AKI) in adventure sports athletes.

Objectives: To describe the prevalence of AKI in participants in the Endeavor Team Challenge, a 30-hour, 40-mile adventure race.

Methods: In this prospective observational study, body weights were recorded at race registration. At the finish line, blood sample results by point-of-care testing and weights were recorded. Changes in serum creatinine (Cr) from an estimated baseline value and severity of AKI were calculated, with “risk of injury” defined as 1.5 x baseline Cr, and “injury” defined as 2 x baseline Cr. These two categories of AKI were combined to calculate the total prevalence. 

Results: There were 88 enrolled study participants with complete data available on 46 (52%). The mean age of those enrolled in the study was 36.8 years (+/- 7.7), 90% were males, and body mass index (BMI) was 25.7 kg/m2 (+/- 2.4). Of the competitors who completed the study, 34 (73%) had some degree of AKI, with 27 (58%) found to be at "risk" and seven (15%) with "injury". There was a significant correlation between weight loss and elevated Cr (r = -0.29, p = 0.047), with a trend towards nonsteroidal anti-inflammatory drug (NSAID) use being correlated with AKI (p = 0.058).

Conclusion: Acute kidney injury was observed in the majority of the Endeavor Team Challenge adventure racers, similar to what has been observed in multistage ultramarathons, and greater than after standard marathons and single-stage ultramarathons.



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Original article
peer-reviewed

Biochemistry in Endeavor Adventure Racers Study (BEARS)


Author Information

Matthew Wetschler Corresponding Author

School of Medicine, Stanford University

David Radler

School of Medicine, Stanford University

Mark Christensen

School of Medicine, Stanford University

Sean Rundell

Department of Rehabilitation Medicine, University of Washington

Grant Lipman

School of Medicine, Stanford University


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Stanford Institutional Review Board issued approval 30928. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Original article
peer-reviewed

Biochemistry in Endeavor Adventure Racers Study (BEARS)


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Original article
peer-reviewed

Biochemistry in Endeavor Adventure Racers Study (BEARS)

Matthew Wetschler">Matthew Wetschler , David Radler">David Radler, Mark Christensen">Mark Christensen, Sean Rundell">Sean Rundell, Grant Lipman">Grant Lipman

  • Author Information
    Matthew Wetschler Corresponding Author

    School of Medicine, Stanford University

    David Radler

    School of Medicine, Stanford University

    Mark Christensen

    School of Medicine, Stanford University

    Sean Rundell

    Department of Rehabilitation Medicine, University of Washington

    Grant Lipman

    School of Medicine, Stanford University


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Stanford Institutional Review Board issued approval 30928. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: February 11, 2017

    DOI

    10.7759/cureus.1024

    Cite this article as:

    Wetschler M, Radler D, Christensen M, et al. (February 11, 2017) Biochemistry in Endeavor Adventure Racers Study (BEARS). Cureus 9(2): e1024. doi:10.7759/cureus.1024

    Publication history

    Received by Cureus: July 08, 2016
    Peer review began: July 12, 2016
    Peer review concluded: January 20, 2017
    Published: February 11, 2017

    Copyright

    © Copyright 2017
    Wetschler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Adventure sports events consist of a combination of two or more endurance disciplines, such as orienteering, running, and rock climbing, that range from a day’s to a week’s duration. No studies have examined acute kidney injury (AKI) in adventure sports athletes.

Objectives: To describe the prevalence of AKI in participants in the Endeavor Team Challenge, a 30-hour, 40-mile adventure race.

Methods: In this prospective observational study, body weights were recorded at race registration. At the finish line, blood sample results by point-of-care testing and weights were recorded. Changes in serum creatinine (Cr) from an estimated baseline value and severity of AKI were calculated, with “risk of injury” defined as 1.5 x baseline Cr, and “injury” defined as 2 x baseline Cr. These two categories of AKI were combined to calculate the total prevalence. 

Results: There were 88 enrolled study participants with complete data available on 46 (52%). The mean age of those enrolled in the study was 36.8 years (+/- 7.7), 90% were males, and body mass index (BMI) was 25.7 kg/m2 (+/- 2.4). Of the competitors who completed the study, 34 (73%) had some degree of AKI, with 27 (58%) found to be at "risk" and seven (15%) with "injury". There was a significant correlation between weight loss and elevated Cr (r = -0.29, p = 0.047), with a trend towards nonsteroidal anti-inflammatory drug (NSAID) use being correlated with AKI (p = 0.058).

Conclusion: Acute kidney injury was observed in the majority of the Endeavor Team Challenge adventure racers, similar to what has been observed in multistage ultramarathons, and greater than after standard marathons and single-stage ultramarathons.



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Matthew Wetschler

School of Medicine, Stanford University

For correspondence:
matthew.wetschler@gmail.com

David Radler, M.D.

School of Medicine, Stanford University

Mark Christensen

School of Medicine, Stanford University

Sean Rundell

Department of Rehabilitation Medicine, University of Washington

Grant Lipman

School of Medicine, Stanford University

Matthew Wetschler

School of Medicine, Stanford University

For correspondence:
matthew.wetschler@gmail.com

David Radler, M.D.

School of Medicine, Stanford University

Mark Christensen

School of Medicine, Stanford University

Sean Rundell

Department of Rehabilitation Medicine, University of Washington

Grant Lipman

School of Medicine, Stanford University