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Acute Kidney Injury Biomarkers in Marathon Runners: Systematic Review and Meta-Analysis
Daniel-Corneliu Leucuța1, Loredana-Ioana Trif1, Oana Almășan2
1Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
Medicina (Kaunas, Lithuania)
|October 29, 2025
Summary
Marathon running significantly elevates kidney injury biomarkers immediately after the race. Different biomarker patterns emerge post-marathon, with some remaining elevated 24 hours later.
Area of Science:
- Nephrology
- Exercise Physiology
- Biomarker Research
Background:
- Marathon running is a strenuous physical activity.
- Acute kidney injury (AKI) can occur in athletes.
- Understanding kidney biomarker changes post-marathon is crucial.
Purpose of the Study:
- To quantify changes in renal biomarkers before, immediately after, and 24 hours post-marathon.
- To identify potential biomarkers for diagnosing exercise-induced AKI.
- To describe the temporal dynamics of these biomarkers.
Main Methods:
- Systematic review and random effects meta-analysis of studies on marathon runners and AKI biomarkers.
- Inclusion criteria: studies reporting AKI-related biomarkers in marathon runners.
- Databases searched: PubMed, EMBASE, Web of Science, LILACS. Risk of bias assessed using NHLBI pre-post tool.
Main Results:
- Most kidney biomarkers showed significant increases immediately after the marathon compared to baseline.
- Notable increases observed in Tissue Inhibitor of Metalloproteinases-2* Insulin-like Growth Factor Binding Protein-7 (TIMP-2*IGFBP), copeptin, urinary Liver-type Fatty Acid Binding Protein (L-FABP), urinary Monocyte Chemoattractant Protein-1 (MCP-1), IGFBP-7, urinary Chitinase 3-like Protein 1 (YKL-40), and TIMP-2.
- Distinct temporal patterns of biomarker evolution were identified, with some remaining elevated 24 hours post-race.
Conclusions:
- Marathon running induces significant elevations in kidney injury biomarkers.
- Specific biomarkers like TIMP-2*IGFBP, copeptin, L-FABP, MCP-1, IGFBP-7, YKL-40, and TIMP-2 show promise for AKI diagnosis in athletes.
- The dynamic changes in biomarkers post-marathon provide insights into kidney stress and recovery.
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