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Exercise-associated hyponatremia in marathon runners: a two-year experience
D P Davis1, J S Videen, A Marino
1Department of Emergency Medicine, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103-8676, USA.
The Journal of Emergency Medicine
|June 12, 2001
Summary
Exercise-associated hyponatremia is linked to excessive fluid intake, female gender, slower race times, and NSAID use. Early hypertonic saline treatment improved outcomes for marathon runners with hyponatremia.
Area of Science:
- Sports Medicine
- Endocrinology
- Emergency Medicine
Background:
- Exercise-associated hyponatremia (EAH) is a potentially dangerous condition in endurance athletes.
- Risk factors and optimal treatment strategies for EAH require further definition.
Purpose of the Study:
- To define the pathophysiology, risk factors, and therapeutic approach for EAH.
- To evaluate the efficacy and safety of hypertonic saline (HTS) in treating EAH.
Main Methods:
- Retrospective review of marathon runners presenting to Emergency Departments (EDs) in 1998 to identify risk factors.
- Prospective evaluation of an HTS treatment algorithm in 1999 marathon runners.
Main Results:
- EAH patients were more likely to be female, use NSAIDs, and have slower race times.
- Excessive fluid consumption was reported by hyponatremic runners.
- HTS treatment in 1999 led to faster sodium correction and fewer complications compared to 1998.
Conclusions:
- EAH is associated with excessive fluid intake, female gender, slower race times, and NSAID use.
- Early HTS administration appears safe and effective for managing EAH in selected athletes.