Urine dipstick analysis for identification of runners susceptible to acute kidney injury following an ultramarathon |
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| Authors: | Martin D Hoffman Kristin J Stuempfle Kevin Fogard Tamara Hew-Butler James Winger Robert H Weiss |
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| Institution: | 1. Department of Physical Medicine &2. Rehabilitation, Department of Veterans Affairs , Northern California Health Care System , Sacramento , CA;3. Department of Physical Medicine &4. Rehabilitation , University of California Davis Medical Center , Sacramento , CA martin.hoffman@va.gov;6. Health Sciences Department , Gettysburg College , Gettysburg , PA;7. Rehabilitation, Department of Veterans Affairs , Northern California Health Care System , Sacramento , CA;8. Exercise Science Program, Oakland University , Rochester , MI;9. Department of Family Medicine , Loyola Stritch School of Medicine , Maywood , IL;10. Department of Medicine, Department of Veterans Affairs , Northern California Health Care System , Sacramento , CA;11. Division of Nephrology, Department of Internal Medicine , University of California Davis Medical Center , Sacramento , CA |
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| Abstract: | Abstract This study examined whether urine dipstick testing might be useful to predict the development of acute kidney injury after an ultramarathon. Participants in the 2011 161-km Western States Endurance Run underwent post-race blood and urine dipstick analyses. Of the 310 race finishers, post-race urine dipstick testing was completed on 152 (49%) and post-race blood also was obtained from 150 of those runners. Based on “injury” and “risk” criteria for acute kidney injury of blood creatinine 2.0 and 1.5 times estimated baseline, respectively, 4% met the criteria for injury and an additional 29–30% met the criteria for risk of injury. Those meeting the injury criteria had higher creatine kinase concentrations (P < 0.001) than those not meeting the criteria. Urine dipstick tests that read positive for at least 1+ protein, 3+ blood, and specific gravity ≥ 1.025 predicted those meeting the injury criteria with sensitivity of 1.00 (95% confidence interval CI] 0.54–1.00), specificity of 0.76 (95% CI 0.69–0.83), positive predictive value of 0.15 (95% CI 0.06–0.30), negative predictive value of 1.00 (95% CI 0.97–1.00), and likelihood ratio for a positive test of 4.2. We conclude that urine dipstick testing was successfully able to identify those individuals meeting injury criteria for acute kidney injury with excellent sensitivity and specificity. |
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| Keywords: | exercise rhabdomyolysis running urinalysis |
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