Physiological and Pathophysiological Responses to Ultramarathon Running in Non-elite Runners

Florian Hoppel; Elisa Calabria; Dominik Pesta; Wilhelm Kantner-Rumplmair; Erich Gnaiger; Martin Burtscher

doi:10.3389/fphys.2019.01300

Physiological and Pathophysiological Responses to Ultramarathon Running in Non-elite Runners

Front Physiol. 2019 Oct 17:10:1300. doi: 10.3389/fphys.2019.01300. eCollection 2019.

Authors

Florian Hoppel^{1

2}, Elisa Calabria³, Dominik Pesta^{2

4

5}, Wilhelm Kantner-Rumplmair⁶, Erich Gnaiger^{1

7}, Martin Burtscher²

Affiliations

¹ Oroboros Instruments, Innsbruck, Austria.
² Department of Sport Science, University of Innsbruck, Innsbruck, Austria.
³ Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
⁴ Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich-Heine University, Düsseldorf, Germany.
⁵ German Center for Diabetes Research, München-Neuherberg, Germany.
⁶ Psychosomatic Pain Ambulance, University Hospital for Medical Psychology and Psychotherapy, Innsbruck, Austria.
⁷ D. Swarovski Research Laboratory, Department of Visceral, Transplant Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.

Abstract

Ultramarathon running represents a major physical challenge even for elite athletes. Runners wellbeing may be challenged by fluid and electrolyte disturbances, hemolysis and skeletal muscle damage, decline in hepatic function and kidney injury. We hypothesized that these effects may even be exacerbated in non-elite runners. Physiological, hematological and biochemical parameters of ten males (26-45 years, weekly training time 8.5 h), participating in a mountain ultramarathon (67 km; approximately 4,500 m of total ascent), were determined before (PRE), immediately after finishing the ultramarathon (POST), and 24 h after the individual finish (REC). Race times of the 8 finishers (2 drop-outs due to hot ambient temperature) varied between 10.4 and 16.1 h, which almost represents the range of the entire starter field (8.82 h-17.47 h). The following changes in mean values of selected markers for skeletal muscle damage and kidney injury were observed from PRE to POST: creatine kinase (CK) + 1289%, lactate dehydrogenase (LDH) + 87%, serum creatinine (CR) + 72%, blood urea nitrogen (BUN) + 96%, and estimated glomerular filtration rate (eGFR) - 45%. Values of CK + 1447%, LDH + 56%, and BUN + 71% remained elevated at REC. White blood cells were increased (+ 137%) only POST. In conclusion, CK and LDH levels and leucocytosis may be considered to be relatively harmless "side-effects" of prolonged running in this group of male subjects with rather moderate ultramarathon experience and training status. However, acute kidney injury may become clinically relevant in this population under the certain conditions, which should be considered by responsible race managers and medical advisors.

Keywords: acute kidney injury; health effects; immune system; muscle damage; ultramarathon running.