Acute renal failure in four Comrades Marathon runners ingesting the same electrolyte supplement: Coincidence or causation?
Abstract
Objectives. To evaluate common factors associated with the development of acute renal failure (ARF) in Comrades Marathon runners.
Methods. This was a retrospective case series of 4 runners hospitalised post-race with ARF in the 89 km 2010 Comrades Marathon. The outcome measures were incidence of analgesic use, levels of creatine phosphokinase (CPK) and degree of electrolyte supplementation (sodium, potassium, calcium and magnesium).
Results. The prevalence of ARF was 1/4 125 runners. They presented with rhabdomyolysis (mean admission CPK of 36 294 IU) and hyponatraemia (mean admission blood sodium level of 133 mEq/l). All had ingested an analgesic during the run (3 ingested a non-steroidal anti-inflammatory drug) and the same readily available anti-cramp electrolyte supplement. The average amount of supplemental sodium (452 mg), potassium (393 mg), calcium (330 mg) and magnesium (154 mg) ingested via this particular electrolyte supplement before and during the run did not exceed
the recommended upper limits of daily intake. Three of the runners were Comrades Marathon novices.
Conclusions. There is a continuing need to clarify the specific cluster variants that cause ARF in Comrades Marathon runners, as the risk factors appear to have evolved since the first case was described over 40 years ago.
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.
