Urine dipstick analysis for identification of runners susceptible to acute kidney injury following an ultramarathon

Martin D. Hoffman, Kristin J. Stuempfle, Kevin Fogard, Tamara Hew-Butler, James Winger, Robert H Weiss

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

This study examined whether urine dipstick testing might be useful to predict the development of acute kidney injury after an ultramarathon. Participants in the 2011 161-km Western States Endurance Run underwent post-race blood and urine dipstick analyses. Of the 310 race finishers, post-race urine dipstick testing was completed on 152 (49%) and post-race blood also was obtained from 150 of those runners. Based on "injury" and "risk" criteria for acute kidney injury of blood creatinine 2.0 and 1.5 times estimated baseline, respectively, 4% met the criteria for injury and an additional 29-30% met the criteria for risk of injury. Those meeting the injury criteria had higher creatine kinase concentrations (P < 0.001) than those not meeting the criteria. Urine dipstick tests that read positive for at least 1+ protein, 3+ blood, and specific gravity ≥ 1.025 predicted those meeting the injury criteria with sensitivity of 1.00 (95% confidence interval [CI] 0.54-1.00), specificity of 0.76 (95% CI 0.69-0.83), positive predictive value of 0.15 (95% CI 0.06-0.30), negative predictive value of 1.00 (95% CI 0.97-1.00), and likelihood ratio for a positive test of 4.2. We conclude that urine dipstick testing was successfully able to identify those individuals meeting injury criteria for acute kidney injury with excellent sensitivity and specificity.

Original languageEnglish (US)
Pages (from-to)20-31
Number of pages12
JournalJournal of Sports Sciences
Volume31
Issue number1
DOIs
StatePublished - Jan 2013

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Acute Kidney Injury
Urine
Wounds and Injuries
Confidence Intervals
Specific Gravity
Creatine Kinase
Blood Proteins
Creatinine
Sensitivity and Specificity

Keywords

  • exercise
  • rhabdomyolysis
  • running
  • urinalysis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Urine dipstick analysis for identification of runners susceptible to acute kidney injury following an ultramarathon. / Hoffman, Martin D.; Stuempfle, Kristin J.; Fogard, Kevin; Hew-Butler, Tamara; Winger, James; Weiss, Robert H.

In: Journal of Sports Sciences, Vol. 31, No. 1, 01.2013, p. 20-31.

Research output: Contribution to journalArticle

Hoffman, Martin D. ; Stuempfle, Kristin J. ; Fogard, Kevin ; Hew-Butler, Tamara ; Winger, James ; Weiss, Robert H. / Urine dipstick analysis for identification of runners susceptible to acute kidney injury following an ultramarathon. In: Journal of Sports Sciences. 2013 ; Vol. 31, No. 1. pp. 20-31.
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