Runners / Cyclists / Walkers : Pay Attention!

The risks of severe renal damage caused by endurance events

Although today’s ultra marathon runners and endurance cycling event participants are very well informed on issues such as training methodology, dietary requirements, hydration, footwear and all the vital do’s and don’ts that a variety of experts have experienced or researched, there are sports people who risk their very lives during endurance events such as the Comrades Ultra Marathon, the Argus cycling tour.
One can have all this information at hand and still end up with serious medical problems after the race.
Why?
Mainly because there are so many variables on race-day that might affect a healthy and well trained athlete such as temperature, humidity, the rate of wind movement across the body, the electrolyte balance in the body, individual susceptibility to various conditions etc.

The main problems related to kidney function during and after a race of this magnitude are:

Bloody urine (haematuria) after excercise

Acute Kidney Failure

Kidney stones

1. Bloody urine is quite common and is often due to repeated impact of the walls of the bladder against each other with subsequent bruising and bleeding. This causes bleeding in the bladder which is evident as the athlete passes urine after the race. This condition should clear within 72 hours as the wall of the bladder is repaired. This can effectively be prevented by trying not to empty the bladder completely just before and also during the race. The half-filled bladder is less likely to get as traumatised as a completely empty one. Although this is a self limiting condition, care must be taken and medical help should be obtained to exclude other, more serious reasons for haematuria. Bleeding in the bladder for periods longer than 48 to 72 hours must be considered as potentially serious and action must be taken.

2. Acute kidney failure is a serious condition and should be treated as such. Although not an uncommon complication of Heatstroke and Dehydration, in a lot of cases endurance athletes developed kidney failure without these predisposing conditions.
Reasons are unclear but seem to indicate that certain individuals might have a specific musculoskeletal defect that causes excessive breakdown of muscle tissues during prolonged exercise, with a resulting leakage of a substance called myoglobin into the blood circulation. This substance ultimately arrives in the kidneys and is filtered but acts as a toxin or poison to the kidneys, causing failure.
This is a variable that is unknown until it happens.
Other reasons for kidney failure on this basis of toxins being filtered are the use of anti-inflammatory drugs or pain killers before and during the race. Popular items are Indomethacin, Ibuprofen, Diclofenac, Aspirin, Naproxen. Athletes take these to prevent pain and reduce inflammation, thus shortening the recovery period. These agents are best left in the medicine cupboard and should not be taken as there is little evidence that they are effective for this application and the risks far outweigh the advantage.

What are the symptoms of acute kidney failure? The first and most obvious one is the inability to pass any significant urine during the first 24 hours after the race. This should immediately trigger the alarm bells and the athlete should seek immediate medical help – preferably a hospital with a renal care unit where dialysis can be, and probably will be performed. Missing this important first sign will cause the person to feel really ill after 36 to 48 hours with severe headaches and nausea. The headache is due to a steep rise in blood pressure as well as the increase in metabolic end-products not being removed from the system. At this stage the failure is well established and will need repeated renal dialysis until the kidneys recover.

Prevention:

Avoid heat stroke

Drink 100 -125ml fluid every 10 to 15 minutes as well as 400 to 500ml before the race.

Sponge frequently and adequately

Do not overestimate your ability, especially near the end of the race (60km and more)

Do not ignore warning signs (weakness, stumbling, headache, nausea, dizziness, apathy)

Abstain from taking anti-inflammatory drugs

Have a test done to determine the general condition of the kidneys well before the race.

Common urine dip tests can exclude kidney infection, certain metabolic disorders.

GFR test (Glomerular Filtration Rate) can determine the rate at which the kidneys filtrate and secrete metabolic waste. This test is available at some pharmacies and also at most pathology labs.

3. There is an abnormally high incidence, about five times normal, of kidney stones among male runners. It must be added that runners most likely to develop stones are those that have been running for the longest time, running the longest distances during training and who are the fastest runners.
Here the message is quite clear:
Always avoid dehydration.
Repeated dehydration can lead to the formation of kidney stones.
Drink optimal volumes of fluid during, but also immediately after the race, especially in hot and humid climates.

Brought to you by Uvongo Pharmacy where we are "Hooked on Health" and where fitness is a way of life.

We accept that sometimes, failing is inevitable.
Failing to try is not an option!

Prostate trouble

Between us men: Prostate trouble?

If you can answer yes to one or more of the following questions, chances are that you are suffering from BPH (Benign Prostate Hypertrophy) or enlargement of the prostate in the absence of malignancy.

1. Abnormally low volume of urine voided each time?
2. Feeling that bladder is not completely empty after urination?
3. Dribbling after urination?
4. Have to get up often during the night to urinate?
5. Do you feel the urge to urinate within two hours after previous urination?
6. Any discomfort and / or urgency when you feel the need to pass water?
7. Is voiding done in “stages”?

Some “comforting” news: About 70% of men will suffer from these symptoms during the average lifetime. It is quite common in men over 45 years and sometimes even much earlier.

Prostate? What/why/where/how?

It is a gland within the male urogenital system with the function of secretion. It is controlled and developed by the male hormones, especially Testosterone. It secretes a substance that contributes to the formation of seminal fluid which enhances the mobility and fertility of spermatozoa. It also prevents this fluid from running into the bladder and redirects it towards the penis. Starting at (normally) the age 40, due to a decrease in Testosterone and a shift in the normal hormonal balance, (all part of the natural phenomenon associated with aging), the prostate becomes enlarged causing a narrowing of the urethra (tube which carries urine from the bladder to the outside). This is what causes difficult urination.

Prostate hypertrophy (enlargement) almost always starts off as a benign condition. It may unfortunately be a much more serious condition than anticipated. It is not something to ignore. The sooner you recognize and talk about this “natural” problem, the sooner you can get a proper diagnosis done by your doctor, hopefully eliminating the more serious forms and consequences of prostate hypertrophy. BPH presents itself in stages:
Early detection during phase I can still be treated and controlled without expensive medicine or surgery.
During phase II proper diagnosis is essential and prescription medicine might be prescribed.
Phase III is much more serious and ultimately might need surgical intervention by a specialist.

How do we avoid stage III?
Early detection and treatment is the answer.
Regular check-ups from the age of 40.
Never ignore the symptoms.
Accept the fact that it is a very real and common problem which can be diagnosed, treated and sometimes prevented.

Advice for a healthier prostate:
A healthy lifestyle, exercise, cutting back on alcohol & tobacco & coffee, low-fat high fibre diet, adequate intake of minerals and vitamins and yearly examinations all form a good base.
The Natural Remedies department at Uvongo Pharmacy strongly suggests the intake of a natural substance called Saw Palmetto, a herbal extract derived from the Serenoa repens plant. This herb, taken regularly can relieve the symptoms and halt the progress of prostate conditions during phase I. This in itself can prevent or delay treatment with harsh chemicals and/or surgical intervention.

Still scared or shy or ignorant? Then you did not read this with complete honesty and it is suggested that you read it again or phone us at 0393150040 to discuss your health and your safety.