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Abstract: FR-PO045

Role of Sweat and Core Body Temperature in AKI During Marathon

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials


  • Mansour, Sherry, Yale University, New Haven, Connecticut, United States
  • Jia, Yaqi, Yale University, New Haven, Connecticut, United States
  • Obeid, Wassim, Yale, New Haven, Connecticut, United States
  • Martin, Thomas, Quinnipiac University, Hamden, Connecticut, United States
  • Pata, Rachel W., Quinnipiac University, Hamden, Connecticut, United States
  • Myrick, Karen M., Quinnipiac University, Hamden, Connecticut, United States
  • Jiang, Lanxin, Yale University , New Haven, Connecticut, United States
  • Thiessen Philbrook, Heather, Yale University, New Haven, Connecticut, United States
  • Kukova, Lidiya, Yale University, New Haven, Connecticut, United States
  • Parikh, Chirag R., Yale University and VAMC, New Haven, Connecticut, United States

The strenuous physical activity of marathons is associated with AKI in runners. Given the increasing participation in marathons, it is important to understand the etiology behind runners’ AKI to allow for future preventative measures. We hypothesized that sodium loss from sweat along with a rise in core body temperature during the race will be associated with AKI via thermoregulatory vasodilation and shunting of blood away from kidneys to muscles and skin. To test this hypothesis we conducted a prospective study of 22 runners participating in the 2017 Hartford Marathon.


Vital signs, blood and urine samples were collected 24 hours pre-marathon, and immediately post-marathon. We measured conventional and novel biomarkers. We also measured continuous core body temperature using Zephyr® technology and sweat volume and sodium using PharmChek® patches during the race. We performed linear regression analyses to determine the association between sweat sodium and core body temperature with kidney injury.


Runners ranged from 22 to 63 years of age, had 2 to 25 years of running experience and 52% were males. Runners lost an estimated median range of 2.34 (0.50 to 7.21) grams of sodium, 2.47 (0.36 to 6.81) liters of volume via sweat and had temperatures of 101.12 (96.44 to 105.8)°F during race. The change in weight ranged from 1.81 (0.18 to 5.08) kg. 56% developed AKI based on creatinine definition and 83% had a positive urine microscopy for acute tubular injury. Runners with AKI and higher sweat sodium had higher increases in several injury, inflammatory and repair biomarkers (Figure). Sweat sodium and temperature were not associated with change in creatinine or urine microscopy during the race.


Runners have substantial rise in core body temperature and extensive weight loss mainly via sweat sodium and volume losses. The mechanisms associated with thermoregulatory vasodilation and associated reduced blood flow to the kidney may provide insights into the pathophysiology of runners' AKI.


  • NIDDK Support