Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists
Introduction: Ultracyclists expose themselves to extreme physical challenges. This study aimed to elucidate the effects of ultracycling on electrolyte and fluid balance and investigate the potential occurrence of peripheral edema. Methods: A total of 4 clinical visits were performed before, during,...
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Elsevier
2024-01-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024923015668 |
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| author | Philipp Gauckler Jana S. Kesenheimer Johannes Leierer Maren Kruus Michael Schreinlechner Fabian Theurl Axel Bauer Sara Denicolò Alexander Egger Beata Seeber Gert Mayer Fiona R. Kolbinger Andreas Kronbichler |
| author_facet | Philipp Gauckler Jana S. Kesenheimer Johannes Leierer Maren Kruus Michael Schreinlechner Fabian Theurl Axel Bauer Sara Denicolò Alexander Egger Beata Seeber Gert Mayer Fiona R. Kolbinger Andreas Kronbichler |
| author_sort | Philipp Gauckler |
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| description | Introduction: Ultracyclists expose themselves to extreme physical challenges. This study aimed to elucidate the effects of ultracycling on electrolyte and fluid balance and investigate the potential occurrence of peripheral edema. Methods: A total of 4 clinical visits were performed before, during, and after a 6-day bicycle ride in 13 ultracyclists (5 female, 8 male) including serial laboratory analyses of blood and urine, bioelectrical impedance, and echocardiography. Throughout the ride, participants continuously tracked fluid intake, measured extremity circumferences daily, and self-tested urinary electrolytes using a point-of-care testing device. Portrait photos were judged by 20 physicians for occurrence of facial and eyelid edema. Results: Participants covered a mean distance of 1205 km and 19,417 vertical meters. From baseline to day 6, body weight remained stable (P = 0.479); however, body composition changed with increasing total body water (TBW) (+1.98 l ± 1.37, P = 0.003) and plasma volume (+18.86 % ± 10.7, P < 0.001). A significant increase in N-terminal pro brain natriuretic peptide (NT-proBNP) (+297.99 ng/l ± 190.42, P < 0.001) until day 6 indicates concomitant cardiac volume overload. Swelling of face and eyelids peaked on day 5 (both P ≤ 0.033). On recovery, changes partly resolved. Although urinary sodium concentration showed a nadir on day 4 (−32.18 mmol/l ± 23.88, P = 0.022), plasma osmolality (+5.69 mmosmol/kg ± 5.88, P = 0.004) and copeptin (+38.28 pg/ml ± 18.90, P < 0.001) increased steadily until day 6. Conclusion: Ultracycling over multiple days induces extracellular volume expansion, peripheral edema, and cardiac volume overload. Renal sodium and water retention is likely contributing to this condition. |
| format | Article |
| id | doaj-art-ee9f98af4c5f49fabdde96a3a2a10b0d |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
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| series | Kidney International Reports |
| spelling | doaj-art-ee9f98af4c5f49fabdde96a3a2a10b0d2025-08-20T03:45:06ZengElsevierKidney International Reports2468-02492024-01-019115216110.1016/j.ekir.2023.10.025Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance CyclistsPhilipp Gauckler0Jana S. Kesenheimer1Johannes Leierer2Maren Kruus3Michael Schreinlechner4Fabian Theurl5Axel Bauer6Sara Denicolò7Alexander Egger8Beata Seeber9Gert Mayer10Fiona R. Kolbinger11Andreas Kronbichler12Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria; Correspondence: Philipp Gauckler, Anichstraße 35, Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria.Department of Psychology, University of Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, AustriaCentral Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, AustriaDepartment of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, AustriaDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, GermanyDepartment of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, AustriaIntroduction: Ultracyclists expose themselves to extreme physical challenges. This study aimed to elucidate the effects of ultracycling on electrolyte and fluid balance and investigate the potential occurrence of peripheral edema. Methods: A total of 4 clinical visits were performed before, during, and after a 6-day bicycle ride in 13 ultracyclists (5 female, 8 male) including serial laboratory analyses of blood and urine, bioelectrical impedance, and echocardiography. Throughout the ride, participants continuously tracked fluid intake, measured extremity circumferences daily, and self-tested urinary electrolytes using a point-of-care testing device. Portrait photos were judged by 20 physicians for occurrence of facial and eyelid edema. Results: Participants covered a mean distance of 1205 km and 19,417 vertical meters. From baseline to day 6, body weight remained stable (P = 0.479); however, body composition changed with increasing total body water (TBW) (+1.98 l ± 1.37, P = 0.003) and plasma volume (+18.86 % ± 10.7, P < 0.001). A significant increase in N-terminal pro brain natriuretic peptide (NT-proBNP) (+297.99 ng/l ± 190.42, P < 0.001) until day 6 indicates concomitant cardiac volume overload. Swelling of face and eyelids peaked on day 5 (both P ≤ 0.033). On recovery, changes partly resolved. Although urinary sodium concentration showed a nadir on day 4 (−32.18 mmol/l ± 23.88, P = 0.022), plasma osmolality (+5.69 mmosmol/kg ± 5.88, P = 0.004) and copeptin (+38.28 pg/ml ± 18.90, P < 0.001) increased steadily until day 6. Conclusion: Ultracycling over multiple days induces extracellular volume expansion, peripheral edema, and cardiac volume overload. Renal sodium and water retention is likely contributing to this condition.http://www.sciencedirect.com/science/article/pii/S2468024923015668arginine vasopressinexercisefluid overloadoverhydrationperipheral edemaultra-endurance cycling |
| spellingShingle | Philipp Gauckler Jana S. Kesenheimer Johannes Leierer Maren Kruus Michael Schreinlechner Fabian Theurl Axel Bauer Sara Denicolò Alexander Egger Beata Seeber Gert Mayer Fiona R. Kolbinger Andreas Kronbichler Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists Kidney International Reports arginine vasopressin exercise fluid overload overhydration peripheral edema ultra-endurance cycling |
| title | Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists |
| title_full | Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists |
| title_fullStr | Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists |
| title_full_unstemmed | Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists |
| title_short | Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists |
| title_sort | exercise induced fluid retention cardiac volume overload and peripheral edema in ultra distance cyclists |
| topic | arginine vasopressin exercise fluid overload overhydration peripheral edema ultra-endurance cycling |
| url | http://www.sciencedirect.com/science/article/pii/S2468024923015668 |
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