Acute Kidney Injury (AKI) is common in prolonged endurance events. Risk factors for exercise-associated AKI include: the exercise itself, heat, hypohydration, muscle breakdown and non-steroidal anti-inflammatory drug (NSAID) use. Prior research from our laboratory showed the hypohydration during high-intensity running increased a biomarker of AKI (urine osmolality-corrected kidney injury molecule 1). Therefore, the current study will now investigate the effect of manipulating hydration status during cycling on biomarkers of AKI.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
14
Water intake will be manipulated in both arms to create a hypohydrated state and a euhydrated state, post-exercise
Loughborough University
Loughborough, United Kingdom
Changes in urinary Kidney Injury Molecule 1 (uKIM-1) (uncorrected/raw values and urine osmolality-corrected values)
A novel protein biomarker for acute kidney injury
Time frame: Pre-exercise (baseline), post-exercise (immediately after the intervention), 24 hours post-baseline
Changes in urinary neutrophil gelatinase-associated lipocalin (uNGAL) (uncorrected/raw values and urine osmolality-corrected values)
A novel protein biomarker for acute kidney injury
Time frame: Pre-exercise (baseline), post-exercise (immediately after the intervention), 24 hours post-baseline
Changes in urine osmolality
A measure of urine concentration.
Time frame: Pre-exercise (baseline) and post-exercise (immediately after the intervention), as well as all urine produced from post-exercise until 24 hours post-baseline
Changes in serum creatinine
Serum creatinine is a marker of kidney function
Time frame: Pre-exercise (baseline), post-exercise (immediately post-exercise), 24 hours post-baseline
Incidence of Acute Kidney Injury (as determined by changes in serum creatinine)
A rise in serum creatinine of 1.5 fold or more from baseline will be defined as acute kidney injury
Time frame: Pre-exercise (baseline), post-exercise (immediately post-exercise), 24 hours post-baseline
Plasma volume changes
Time frame: Pre-exercise (baseline), post-exercise (immediately after the intervention), 24 hours post-baseline
Changes in serum osmolality
The gold standard marker of hydration status
Time frame: Pre-exercise (baseline), post-exercise (immediately after the intervention), 24 hours post-baseline
Body mass changes
Time frame: pre-exercise (baseline), throughout exercise, post-exercise (immediately after the intervention), 24 hours post-baseline
Changes in creatine kinase
A marker of muscle damage
Time frame: Pre-exercise (baseline), post-exercise (immediately after the intervention), 24 hours post-baseline
Changes in lactate dehydrogenase
A marker of muscle damage
Time frame: Pre-exercise (baseline), post-exercise (immediately after the intervention), 24 hours post-baseline
Ad libitum energy (Kj), carbohydrate (g), sugar (g), protein (g), fat (g), saturated fat (g), sodium (g) and water intake (g).
Participants will complete a weighed food and fluid diary, using a set of food scales and a diary, to record all food and fluid that they ingest. This data will then be analysed using dietary analysis software (e.g. Nutritics)
Time frame: from post-exercise (immediately after the intervention) until 24 hours post-baseline
Changes in headache scores
Participants will be asked to rate their headache on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in nausea scores
Participants will be asked to rate their nausea on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in dizziness scores
Participants will be asked to rate their dizziness on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in thirst scores
Participants will be asked to rate their thirst on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in thermal comfort scores
Participants will be asked to rate their thermal comfort on a scale of -10 to 10, with -10 being cold impossible to bear and 10 being heat impossible to bear
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in gastrointestinal comfort scores
Participants will be asked to rate their gastrointestinal comfort on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in stomach fullness scores
Participants will be asked to rate their stomach fullness on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in stomach bloatedness scores
Participants will be asked to rate their stomach bloatedness on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in urge to vomit scores
Participants will be asked to rate their urge to vomit on a scale of 0-10, with higher scores meaning a worse outcome .
Time frame: pre-exercise (baseline), every 30 minutes during exercise (30, 60,90 and 120 minutes), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in urinary creatinine
Time frame: pre-exercise (baseline), post-exercise (immediately after the intervention) and 24 hours post-baseline
Changes in heart rate
Provides insight into exercise intensity
Time frame: Will be monitored throughout the exercise intervention, at 15 minute intervals (15 minutes, 30 minutes, 45 minutes, 60 minutes, 75 minutes, 90 minutes, 105 minutes and 120 minutes)
changes in rating of perceived exertion
Provides insight into exercise intensity
Time frame: Will be monitored throughout the exercise intervention, at 30 minute intervals (30 minutes, 60 minutes, 90 minutes and 120 minutes)
Changes in aural temperature
in-ear temperature
Time frame: Will be determined immediately prior to the exercise intervention (at rest) and then throughout the exercise intervention at 15 minute intervals (15 minutes, 30 minutes, 45 minutes, 60 minutes, 75 minutes, 90 minutes, 105 minutes and 120 minutes)
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