Maintained Serum Sodium in Male Ultra-Marathoners - The Role of Fluid Intake, Vasopressin, and Aldosterone in Fluid and Electrolyte Regulation

IntroductionThe primary mechanism through which the development of exercise-associated hyponatraemia (EAH) occurs is excessive fluid intake. However, many internal and external factors have a role in the maintenance of total body water and non-steroidal anti-inflammatory medications (NSAIDs) have been implicated as a risk factor for the development of EAH. This study aimed to compare serum sodium concentrations ([Na]) in participants taking an NSAID before or during a marathon (NSAID group) and those not taking an NSAID (control group).MethodsParticipants in a large city marathon were recruited during race registration to participate in this study. Blood samples and body mass measurements took place on the morning of the marathon and immediately post marathon. Blood was analysed for [Na]. Data collected via questionnaires included athlete demographics, NSAID use and estimated fluid intake.ResultsWe obtained a full data set for 28 participants. Of these 28 participants, 16 took an NSAID on the day of the marathon. The average serum [Na] decreased by 2.1 mmol/L in the NSAID group, while it increased by 2.3 mmol/L in the control group NSAID group (p=0.0039). Estimated fluid intake was inversely correlated with both post-marathon serum [Na] and ∆ serum [Na] (r=−0.532, p=0.004 and r=−0.405 p=0.032, respectively).ConclusionSerum [Na] levels in participants who used an NSAID decreased over the course of the marathon while it increased in those who did not use an NSAID. Excessive fluid intake during a marathon was associated with a lower post-marathon serum [Na].

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Role of frequency volume chart for the assessment of urinary incontinence in men

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184044 ◽

2018 ◽

Vol 6 (10) ◽

pp. 3346

Author(s):

Debasis Samaddar ◽

Dilip Kumar Pal

Keyword(s):

Urinary Incontinence ◽

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Male Patient ◽

Lower Urinary Tract ◽

Oral Fluid ◽

Fluid Intake ◽

Urinary Tract Symptoms ◽

Lower Urinary

Background: This study was conducted to evaluate the role of FVC (frequency volume chart) in the male patient with urinary incontinence. That will definitely help to evaluate patient’s objective lower urinary tract symptoms including incontinence and guide to manage those symptoms. But there are less number of reported studies showing role of FVC in men with urinary incontinence.Methods: Male patient (19-60 years) presenting with incontinence symptoms from 1st February 2018 to 30th July 2018, were enrolled in the study. They were asked to record the time and volume of each oral fluid intake, voided volume for 3 consecutive days and put tick in the column of incontinence in the FVC if present.Results: Total 205 male patients presented with incontinence symptoms were evaluated, they were divided into 3 age groups (19-32, 33-46 and 47-60 years). Mean incontinence were found 2.65 (19-32 years). 2.99 (33-46 years) and 3.13 (47-60 years). In 47-60 years group total oral fluid intake is positively correlated with frequency (p <0.05) but not in other groups. Correlation of Nocturia with incontinence (p >0.05) and frequency with incontinence (p >0.05) were not statistically significant in any age groups.Conclusions: The FVC is the registration of voiding parameters by patient in his own environment. Assessment of lower urinary tract symptoms based on a history alone is not accurate, value of FVC are found to be consistent and accurate, so it will guide us to initiate management in male with urinary incontinence and also help to assess treatment responsiveness.

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Renal function in the laboratory rat: a student exercise.

AJP Advances in Physiology Education ◽

10.1152/advances.1995.268.6.s49 ◽

1995 ◽

Vol 268 (6) ◽

pp. S49 ◽

Cited By ~ 1

Author(s):

R L Walker ◽

M E Olson

Keyword(s):

Renal Function ◽

Fluid Intake ◽

Tap Water ◽

Extracellular Fluid ◽

Control Group ◽

Blood Samples ◽

Treatment Groups ◽

Laboratory Rats ◽

Group A

Because of the increased concern over use of human body fluids in physiology teaching laboratories, we developed an exercise in renal function that utilizes laboratory rats. The purpose is to demonstrate the role of the kidneys in the homeostatic control of extracellular fluid volume, plasma ionic concentrations, and osmolarity. Three treatment groups are utilized: a volume-expanded (access to 1 g/100 ml sucrose) group, a volume-expanded and salt-loaded (access to 0.9 g/100 ml NaCl) group, and a volume-depleted (water-deprived) group. A normovolemic control group (access to tap water) is also included. Rats are housed individually in metabolic cages that allow accurate measurement of fluid intake and urine output. Blood samples are removed via cardiac puncture. The animals recover from this procedure and can be reutilized within 2-3 wk. When class data are pooled, clear trends are seen that demonstrate the volume-, osmo-, and ionoregulatory abilities of the kidneys.

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Role of medullary emetic chemoreceptor trigger zone (CT zone) in postnephrectomy vomiting in dogs

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1959.197.4.850 ◽

1959 ◽

Vol 197 (4) ◽

pp. 850-852 ◽

Cited By ~ 15

Author(s):

H. L. Borison ◽

L. M. Hebertson

Keyword(s):

Spinal Cord ◽

Serum Sodium ◽

Guanidine Hydrochloride ◽

Rapid Decline ◽

Bilateral Nephrectomy ◽

Sodium Potassium ◽

Chemoreceptor Trigger Zone ◽

Serum Chloride ◽

Trigger Zone

Latencies for vomiting following bilateral nephrectomy in control dogs, after gut denervation by transthoracic vagotomy and spinal cord transection at T4, and after ineffective ablation of the CT zone, were all within a range of 16–48 hours. By contrast, in dogs with effective lesions of the CT zone, the latency for vomiting after nephrectomy was prolonged to a range of 54–147 hours and two dogs died after 5 and 6 days, respectively, without vomiting. Chlorpromazine and morphine did not prolong the latency for vomiting after nephrectomy. Guanidine hydrochloride, 75 mg/kg i.v., evoked vomiting in all of seven control dogs, but only in one of nine dogs with effective lesions of the CT zone. Except for a more rapid decline of serum chloride in control dogs, serum sodium, potassium, bicarbonate and blood urea nitrogen followed the same pattern after nephrectomy in control and CT-zone ablated dogs.

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Parenteral Hydration in Patients with Advanced Cancer (DRAFT)

10.1093/med/9780190658618.003.0020 ◽

2018 ◽

Author(s):

Carlos Eduardo Paiva ◽

Bianca Sakamoto Ribeiro Paiva

Keyword(s):

Quality Of Life ◽

Advanced Cancer ◽

Clinical Case ◽

Fluid Intake ◽

Hospice Care ◽

Important Study ◽

The Common ◽

To Receive

There has been much debate about the role of parenteral hydration in the last weeks and days of life. In this important study, 129 patients with advanced cancer receiving hospice care with mild to moderate dehydration who were no longer able to maintain adequate fluid intake were randomized to receive parenteral hydration of either 1 L or 100 ml of normal saline per day subcutaneously. Parenteral hydration did not significantly improve the symptoms related to dehydration, the occurrence of delirium, fatigue, quality of life, and overall survival. At the end of the chapter, a clinical case leads readers to consider the common practice of parenteral hydration.

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The role of the renal concentrating mechanisms in the regulation of serum sodium concentration

The American Journal of Medicine ◽

10.1016/0002-9343(77)90312-6 ◽

1977 ◽

Vol 62 (2) ◽

pp. 165-169 ◽

Cited By ~ 7

Author(s):

Juha P. Kokko

Keyword(s):

Serum Sodium ◽

Sodium Concentration ◽

Serum Sodium Concentration

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Optimisation serum sodium concentrations in heart failure patients: The potential role of tolvaptan

Heart Lung and Circulation ◽

10.1016/j.hlc.2015.06.245 ◽

2015 ◽

Vol 24 ◽

pp. S214

Author(s):

M. Kobayashi ◽

K. Teraoka ◽

Y. Iwasaki ◽

M. Watanabe ◽

K. Takazawa ◽

...

Keyword(s):

Heart Failure ◽

Serum Sodium ◽

Potential Role ◽

Heart Failure Patients

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Sodium Replacement and Plasma Sodium Drop During Exercise in the Heat When Fluid Intake Matches Fluid Loss

Journal of Athletic Training ◽

10.4085/1062-6050-44.2.117 ◽

2009 ◽

Vol 44 (2) ◽

pp. 117-123 ◽

Cited By ~ 27

Author(s):

Costas A. Anastasiou ◽

Stavros A. Kavouras ◽

Giannis Arnaoutis ◽

Aristea Gioxari ◽

Maria Kollia ◽

...

Keyword(s):

Plasma Volume ◽

Serum Sodium ◽

Prolonged Exercise ◽

Fluid Intake ◽

Sodium Intake ◽

Plasma Osmolality ◽

Plasma Sodium ◽

Fluid Loss ◽

Electrolyte Balance ◽

Sodium Replacement

Abstract Context: Sodium replacement during prolonged exercise in the heat may be critically important to maintaining fluid and electrolyte balance and muscle contractility. Objective: To examine the effectiveness of sodium-containing sports drinks in preventing hyponatremia and muscle cramping during prolonged exercise in the heat. Design: Randomized crossover study. Patients or Other Participants: Thirteen active men. Intervention(s): Participants completed 4 trials of an exercise protocol in the heat (30°C) consisting of 3 hours of exercise (alternating 30 minutes of walking and cycling at a heart rate of 130 and 140 beats per minute, respectively); a set of standing calf raises (8 sets of 30 repetitions); and 45 minutes of steep, brisk walking (5.5 kmṡh−1 on a 12% grade). During exercise, participants consumed fluids to match body mass loss. A different drink was consumed for each trial: carbohydrate-electrolyte drink containing 36.2 mmol/L sodium (HNa), carbohydrate-electrolyte drink containing 19.9 mmol/L sodium (LNa), mineral water (W), and colored and flavored distilled water (PL). Main Outcome Measure(s): Serum sodium, plasma osmolality, plasma volume changes, and muscle cramping frequency. Results: During both HNa and LNa trials, serum sodium remained relatively constant (serum sodium concentration at the end of the protocol was 137.3 mmol/L and 136.7 mmol/L, respectively). However, a clear decrease was observed in W (134.5 ± 0.8 mmol/L) and PL (134.4 ± 0.8 mmol/L) trials compared with HNa and LNa trials (P < .05). The same trends were observed for plasma osmolality (P < .05). Albeit not significant, plasma volume was preserved during the HNa and LNa trials, but a reduction of 2.5% was observed in the W and PL trials. None of the volunteers experienced cramping. Conclusions: The data suggest that sodium intake during prolonged exercise in the heat plays a significant role in preventing sodium losses that may lead to hyponatremia when fluid intake matches sweat losses.

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