Marathon running and cell-cycle arrest biomarkers of acute kidney injury

Todd Leckie; Daniel Fitzpatrick; Alan J Richardson; Alex Hunter; Sonia Bains; Rachael Grimaldi; Rob Galloway; Lui G Forni; Luke E Hodgson

doi:10.1016/j.jsams.2022.10.012

Marathon running and cell-cycle arrest biomarkers of acute kidney injury

J Sci Med Sport. 2023 Jan;26(1):14-18. doi: 10.1016/j.jsams.2022.10.012. Epub 2022 Oct 24.

Authors

Todd Leckie¹, Daniel Fitzpatrick², Alan J Richardson³, Alex Hunter⁴, Sonia Bains⁵, Rachael Grimaldi⁶, Rob Galloway⁷, Lui G Forni⁸, Luke E Hodgson⁹

Affiliations

¹ Anaesthetics and Critical Care Department, Worthing Hospital, University Hospitals Sussex NHS Trust, Worthing, UK. Electronic address: todd.leckie@nhs.net.
² School of Sport and Health Sciences, University of Brighton, Brighton, UK. Electronic address: https://twitter.com/drdanfp.
³ School of Sport and Health Sciences, University of Brighton, Brighton, UK. Electronic address: https://twitter.com/alanrichardson_.
⁴ Anaesthetics Department, Royal Devon and Exeter NHS Trust, Exeter, UK. Electronic address: https://twitter.com/docalexhunter.
⁵ Institute of Sport, Exercise and Health, University College London Hospital, London, UK. Electronic address: https://twitter.com/DrSoniaBains.
⁶ Anaesthetics Department, Great Ormond Street Hospital for Children, London, UK.
⁷ Emergency Medicine Department, Royal Sussex County Hospital, University Hospitals Sussex NHS Trust, Brighton, UK. Electronic address: https://twitter.com/DrRobgalloway.
⁸ Critical Care Department, Royal Surrey County Hospital NHS Trust, Guildford, UK. Electronic address: https://twitter.com/ForniLuiG.
⁹ Anaesthetics and Critical Care Department, Worthing Hospital, University Hospitals Sussex NHS Trust, Worthing, UK; Brighton and Sussex Medical School, Brighton, UK. Electronic address: https://twitter.com/drlhodgson.

PMID: 36435729
DOI: 10.1016/j.jsams.2022.10.012

Abstract

Objectives: Endurance exercise is known to cause a rise in serum creatinine. It is not known to what extent this rise reflects renal stress and a potential acute kidney injury (AKI). Increases in Insulin Like Growth Factor Binding Protein 7 (IGFBP7) and Tissue Inhibitor of Metalloprotinases-2 (TIMP-2), urinary biomarkers of cell cycle arrest and renal stress, are associated with the development of AKI in clinical populations.

Design: Repeated measures study.

Methods: Runners were recruited at the 2019 Brighton Marathon (UK) and provided urine and blood samples at baseline, immediately post-race and 24 h post-race. Serum creatinine, urinary creatinine and urinary IGFBP7 and TIMP-2 were analysed from the samples.

Results: Seventy nine participants (23 females, 56 males), aged 43 ± 10 yrs. (mean ± SD), finish time 243 ± 40mins were included for analysis. Serum creatinine increased over the race by 40 ± 26% (p < 0.001), TIMP-2 increased by 555 ± 697% (p < 0.001) and IGFBP7 increased by 1094 ± 1491% (p < 0.001) over the race. A subset of twenty-two participants supplied samples 24 h post-race, reporting values similar to baseline for all variables.

Conclusions: This study is the first to report large rises in IGFBP7 and TIMP-2 following marathon running. This suggests that rises in creatinine are not fully explained by changes in production and clearance and marathon running induces a state of kidney stress and potential injury.

Keywords: Acute kidney injury; Biomarker; Endurance; IGFBP7; Running; TIMP-2.

MeSH terms

Acute Kidney Injury* / diagnosis
Biomarkers
Cell Cycle Checkpoints
Creatinine
Female
Humans
Male
Marathon Running*
Tissue Inhibitor of Metalloproteinase-2

Substances

Creatinine
Tissue Inhibitor of Metalloproteinase-2
Biomarkers