Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists
© 2023 International Society of Nephrology. Published by Elsevier Inc..
Introduction: Ultracyclists expose themselves to extreme physical challenges. This study aimed to elucidate the effects of ultracycling on electrolyte and fluid balance and investigate the potential occurrence of peripheral edema.
Methods: A total of 4 clinical visits were performed before, during, and after a 6-day bicycle ride in 13 ultracyclists (5 female, 8 male) including serial laboratory analyses of blood and urine, bioelectrical impedance, and echocardiography. Throughout the ride, participants continuously tracked fluid intake, measured extremity circumferences daily, and self-tested urinary electrolytes using a point-of-care testing device. Portrait photos were judged by 20 physicians for occurrence of facial and eyelid edema.
Results: Participants covered a mean distance of 1205 km and 19,417 vertical meters. From baseline to day 6, body weight remained stable (P = 0.479); however, body composition changed with increasing total body water (TBW) (+1.98 l ± 1.37, P = 0.003) and plasma volume (+18.86 % ± 10.7, P < 0.001). A significant increase in N-terminal pro brain natriuretic peptide (NT-proBNP) (+297.99 ng/l ± 190.42, P < 0.001) until day 6 indicates concomitant cardiac volume overload. Swelling of face and eyelids peaked on day 5 (both P ≤ 0.033). On recovery, changes partly resolved. Although urinary sodium concentration showed a nadir on day 4 (-32.18 mmol/l ± 23.88, P = 0.022), plasma osmolality (+5.69 mmosmol/kg ± 5.88, P = 0.004) and copeptin (+38.28 pg/ml ± 18.90, P < 0.001) increased steadily until day 6.
Conclusion: Ultracycling over multiple days induces extracellular volume expansion, peripheral edema, and cardiac volume overload. Renal sodium and water retention is likely contributing to this condition.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Kidney international reports - 9(2024), 1 vom: 31. Jan., Seite 152-161 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gauckler, Philipp [VerfasserIn] |
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| Links: |
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| Themen: |
Arginine vasopressin |
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| Anmerkungen: |
Date Revised 06.02.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.ekir.2023.10.025 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368019772 |
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| 100 | 1 | |a Gauckler, Philipp |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 International Society of Nephrology. Published by Elsevier Inc. | ||
| 520 | |a Introduction: Ultracyclists expose themselves to extreme physical challenges. This study aimed to elucidate the effects of ultracycling on electrolyte and fluid balance and investigate the potential occurrence of peripheral edema | ||
| 520 | |a Methods: A total of 4 clinical visits were performed before, during, and after a 6-day bicycle ride in 13 ultracyclists (5 female, 8 male) including serial laboratory analyses of blood and urine, bioelectrical impedance, and echocardiography. Throughout the ride, participants continuously tracked fluid intake, measured extremity circumferences daily, and self-tested urinary electrolytes using a point-of-care testing device. Portrait photos were judged by 20 physicians for occurrence of facial and eyelid edema | ||
| 520 | |a Results: Participants covered a mean distance of 1205 km and 19,417 vertical meters. From baseline to day 6, body weight remained stable (P = 0.479); however, body composition changed with increasing total body water (TBW) (+1.98 l ± 1.37, P = 0.003) and plasma volume (+18.86 % ± 10.7, P < 0.001). A significant increase in N-terminal pro brain natriuretic peptide (NT-proBNP) (+297.99 ng/l ± 190.42, P < 0.001) until day 6 indicates concomitant cardiac volume overload. Swelling of face and eyelids peaked on day 5 (both P ≤ 0.033). On recovery, changes partly resolved. Although urinary sodium concentration showed a nadir on day 4 (-32.18 mmol/l ± 23.88, P = 0.022), plasma osmolality (+5.69 mmosmol/kg ± 5.88, P = 0.004) and copeptin (+38.28 pg/ml ± 18.90, P < 0.001) increased steadily until day 6 | ||
| 520 | |a Conclusion: Ultracycling over multiple days induces extracellular volume expansion, peripheral edema, and cardiac volume overload. Renal sodium and water retention is likely contributing to this condition | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a arginine vasopressin | |
| 650 | 4 | |a exercise | |
| 650 | 4 | |a fluid overload | |
| 650 | 4 | |a overhydration | |
| 650 | 4 | |a peripheral edema | |
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| 700 | 1 | |a Leierer, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Kruus, Maren |e verfasserin |4 aut | |
| 700 | 1 | |a Schreinlechner, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Theurl, Fabian |e verfasserin |4 aut | |
| 700 | 1 | |a Bauer, Axel |e verfasserin |4 aut | |
| 700 | 1 | |a Denicolò, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Egger, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Seeber, Beata |e verfasserin |4 aut | |
| 700 | 1 | |a Mayer, Gert |e verfasserin |4 aut | |
| 700 | 1 | |a Kolbinger, Fiona R |e verfasserin |4 aut | |
| 700 | 1 | |a Kronbichler, Andreas |e verfasserin |4 aut | |
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