Evidence map›Paper›PMID 29259804›Full record

ArticleBMJ open sport & exercise medicine2017

Acute kidney injury associated with endurance events-is it a cause for concern? A systematic review.

L E Hodgson, E Walter, R M Venn, R Galloway, Y Pitsiladis, F Sardat, L G Forni

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open sport & exercise medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Changes in Novel AKI Biomarkers after Exercise. A Systematic Review.International journal of molecular sciences · 2020
    Pooled it
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  9. Observational
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  16. Biomarkers of organ stress and injury following the Boston Marathon.Journal of applied physiology (Bethesda, Md. : 1985) · 2025
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  17. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

L E HodgsonDepartment of Anaesthesia, Western Sussex Hospitals NHS Foundation Trust, West Sussex, UK.
E WalterDepartment of Emergency Medicine, Royal Sussex County Hospital, East Sussex, UK.
R M VennDepartment of Anaesthesia, Western Sussex Hospitals NHS Foundation Trust, West Sussex, UK.
R GallowayFaculty of Health and Medical Sciences, University of Surrey, Surrey, UK.
Y PitsiladisDepartment of Emergency Medicine, Royal Sussex County Hospital, East Sussex, UK.
F SardatDepartment of Intensive Care, Surrey Peri-operative Anaesthesia Critical care collaborative Research group (SPACeR), Royal Surrey County Hospital, Surrey, UK.
L G ForniDepartment of Emergency Medicine, Royal Sussex County Hospital, East Sussex, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA growing body of evidence suggests even small rises in serum creatinine (SCr) are of considerable clinical relevance. Given that participants in endurance events are exposed to potential (repeated) renal insults, a systematic review was undertaken to collate current evidence for acute kidney injury (AKI), complicating such events.

methodsA systematic review of studies and case reports meeting inclusion criteria on Medline and EMBASE (inception to October 2015). Included: studies with markers of renal function before and after endurance or ultraendurance events; case reports of severe AKI. Two reviewers assessed risk of bias using the Newcastle-Ottawa scale.

resultsEleven case report publications (n=27 individuals) of severe AKI, were retrieved, with risk factors including systemic illness or nephrotoxic medications usually identified. From 30 studies of endurance and ultraendurance events, mean rise in SCr was 29 (±12.3) µmol/L after marathon or ultramarathon (17 studies, n=568 participants) events. Where follow-up tests were conducted, SCr returned to baseline within 48 hours. Rises in biomarkers suggest potential parenchymal insult, rather than simply muscle breakdown. However, evidence of long-term deleterious effects is lacking.

conclusionsRaised levels of SCr are reported immediately after endurance events. It is not clear whether this is either clinically significant, or if repeated participation predisposes to long-term sequelae. The aetiology of severe exercise-associated AKI is usually multifactorial, with risk factors generally identified in the rare cases reported. On-site biochemistry, urine analysis and biomarkers of AKI may help identify collapsed runners who are at significant short-term risk and allow suitable follow-up.

Indexed as

acute kidney injurybiomarkersendurance eventsmarathonnon-steroidal anti-inflammatories

Identifiers

PMID29259804
PMCPMC5731225

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.