Exercise associated hyponatremia in endurance sports: a review with practical recommendations
Year: 2020
Type: review
Abstract: Participation in endurance activities is popular and growing. Proper hydration is important for performance and to avoid medical complications. Overconsumption of fluids, in combination with inadequate secretion of the hormone arginine vasopressin can lead to exercise associated hyponatremia (EAH). These two factors are the main underlying mechanism for the development of EAH, leading to water retention and a dilutional hyponatremia. EAH is defined biochemically by serum sodium concentrations < 135 mol/L during or up to 24 hours after exercise. Athletes may be asymptomatic, or symptomatic, with mild cases presenting with non-specific symptoms and signs, such as nausea, vomiting or weight gain. Severe cases or cases of exercise associated hyponatremic encephalopathy (EAHE) may present with headaches, altered mental state, seizures or coma and represent a medical emergency. Treatment is warranted with intravenous hypertonic saline solution and can be lifesaving. Other risk factors include exercise duration over 4 hours, exercising in the heat or humid conditions, event inexperience, inadequate training, slow running pace, high or low body mass index (BMI) and free availability of fluids at races. Prevention can generally be achieved by adhering to appropriate hydration strategies, such as drinking to thirst.
Education of athletes, coaches and medical personnel about EAH is important and may help reducing the incidence of EAH and prevent further fatalities.
Authors: Volker Scheer, Beat Knechtle
Language: Spanish
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3171962851