Summary of 30 studies looking at renal function in endurance events (those in grey did not report SCr prior to the event)
| Study | Year | Event | n | Collapse | NSAID | Prerace SCr (µmol/L) | Postrace SCr | Repeat SCr | Mean SCr rise | Additional markers and notes |
| Riley48 | 1975 | Marathon | 5 | 2 | 94 (±2) | 136 (±6) | 42 | |||
| Noakes64 | 1976 | Ultramarathon | 13 | 97 | 128 | 31 | ||||
| Neviackas49 | 1981 | Marathon | 6 | 84 (range 70–97) | 6 hours: 104 (70–159) | 1 week: 86 (62–97) | 20 | |||
| Irving35 | 1986 | Marathon | 6 | 89 (±3) | 96 (±5) | 24 hours: 86 | 7 | |||
| Kraemer50 | 1986 | Marathon | 20 | 80 (±17) | 120 (±20) | 40 | ||||
| Irving73 | 1989 | 24hour relay marathon | 2 | 81, 86 | 101, 119 | 48 hours: 92 and 92 | 20, 33 | |||
| Nelson58 | 1989 | Marathon | 38 | 81 | 123 | 42 | ||||
| Borkowski57 | 1990 | Marathon | 6 | Urine PCR x 2.6 higher postrace; increase trypsin inhibitor: creatinine ratio at 6–18 hours | ||||||
| Irving65 | 1990a | Ultramarathon | 5 | 1 | Collapse 42; normal 63 (±3) | 55 collapsed, normal 69 (±10) | 66 (±6); 53 | 6, 13 (collapsed) | Urine flow rate, CrCl unchanged (non-collapsed); urine creatinine excretion increase | |
| Irving60 | 1990b | Ultramarathon | 8 | 91 | 110 | 24 hours: 'normal' | 19 | |||
| Irving61 | 1991 | Ultramarathon | 26 | 8 | 3 | Collapsed 88.9 (±8), Controls 104 (±5) | Collapsed 68, Controls 78 | |||
| Holtzhausen51 | 1994 | Marathon | 96 | 36 | Collapsed 141 (±26), Controls 123 (±23) | 24 hours: Collapsed 104 (±13), Control 95 (±13) | ||||
| Kratz52 | 2002 | Marathon | 37 | 88 | 115 | 24 hours: 106 | 27 | |||
| Neumayr75 | 2003 | Ultramarathon cycle | 38 | 88 | 106 | 24 hours: 106 | 18 | |||
| Reid53 | 2004 | Marathon | 134 | 18 | M 110, F 100 (50–160) | NSAID group had higher SCr (p=0.01) | ||||
| Neumayr76 | 2005 | Ultramarathon cycle | 16 | 84 (±15) | 111 (±19) | 83 (±15) | 26 | |||
| Wharam72 | 2006 | Ironman triathalon | 333 | 100 | NSAID 130, controls 120 | Significant increase in NSAID group versus no NSAID (p=0.01) | ||||
| Page74 | 2007 | 60-km mountain run | 123 | 43 | 110 (±2) | F/U<1week: normal | No difference in NSAID users | |||
| Dumke | 2007 | Ultramarathon | 54 | 29 | NSAID 85 (±12), controls: 91 (±15) | NSAID 118 (±25), controls 120 (±27) | 33 versus 29 | No significant difference between groups | ||
| Lippi70 | 2008 | Half-marathon | 17 | 99 (90–113) | 115 (112–130) | 24 hours: 101 (92–113) | 16 | eGFR decreased by 14 | ||
| Mingels54 | 2009 | Marathon | 70 | 86* | 132* | 24 hours: 96 | Cystatin C elevated in 26%—mean increase half as much as creatinine | |||
| McCullough55 | 2011 | Marathon | 25 | 80 (±9) | 106 (±18) | 24 hours: 71 (±9) | 27 | Rise: cystatin C, urine NGAL and kidney injury molecule-1 levels. Resolution<24 hours. | ||
| Mohseni71 | 2011 | Half-marathon | 195 | 78 | 80 | 97 | 17 | |||
| Mydlik56 | 2012 | Half or marathon | 49 | 93 (±10), 87 (±8) | 111 (±15), 112 (±9) | 2–6 days post 103 (±11) | 18, 25 | |||
| Lippi62 | 2012 | Ultramarathon | 16 | 68 (58–76) | 98 (76–118) | 30 | sNGAL x1.6, uNGAL x7.7, uNGAL/creatinine ratio x2.9 increase. 31% eGFR decrease | |||
| Hoffman63 | 2013 | Ultramarathon | 207 | 70 | 9 (4%) AKI ‘Injury’; 62 risk | Urine 1+ protein, 3+ blood and specific gravity>1.025 predicted those with AKI criteria | ||||
| Lipman66 | 2014 | Ultramarathon | 30 | 88 (±18) | 124 (±115) | 35 | ||||
| Christensen68 | 2014 | Ultramarathon | 10 | 60 | 80 | 20 | 25% increase in SCr at 6 hours | |||
| Hou67 | 2015 | Ultramarathon | 26 | 2 | 83 (±10) | 138 (±35) | 72.5 (64–81) | 55 | ||
| Hewing59 | 2015 | Marathon | 167 | 73 (66–82) | 90 (78–111) | 17 | Cystatin C: prerace 0.68 mg/dL, post 0.85 and f/u 0.66 Cystatin C-eGFR prerace 125 ml/min, post 94, f/u 130 |
Mean values (±SD), unless stated, *Median (IQR).
AKI, acute kidney injury; CrCl, creatinine clearance; eGFR, estimated glomerular filtration rate; F, female; M, male; NGAL, neutrophil gelatinase-associated lipocalin; NSAID, non-steroidal anti-inflammatory drug; PCR, protein:creatinine ratio; sNGAL, serum NGAL; SCr, serum creatinine; uNGAL, urine NGAL.