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A multidisciplinary assessment protocol was performed during the first trail of <jats:italic>Cl\u00e9cy<\/jats:italic> (<jats:italic>Normandy France<\/jats:italic>) in November 2021. This allowed an initial assay to be carried out, then at the end of each of the 6 loops of 26\u2009km, and finally after 24\u2009h of recovery. The race extends over 156\u2009km in hilly terrain and 6000\u2009m of elevation gain (D+). The level of impairment according to the RIFLE classification was defined for each runner at each assay. Fifty\u2010five runners were at the start, and the per protocol analysis involved 36 runners (27 men and 9 women, 26 finishers). Fifteen (41.7%) of the riders presented at least one result corresponding to a \u201cRIFLE risk\u201d level. After 24\u2009h of rest, only one runner still had a \u201cRIFLE Risk\u201d. The distance around the marathon seems to be the moment of greatest risk. For the first time, we find an association between this renal risk and the probability of abandonment. Many runners are vulnerable to kidney damage during long\u2010duration exercise, which is why it's important to limit risk situations, such as the use of potentially toxic drugs or hydration disorders. The consumption of NSAIDs (nonsteroidal anti\u2010inflammatory drugs) before or during an ultra\u2010distance race should therefore be prohibited. Attention should be paid to hydration disorders.<\/jats:p>","DOI":"10.14814\/phy2.15935","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T01:24:30Z","timestamp":1714440270000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Increased risk of acute kidney injury in the first part of an ultra\u2010trail\u2014Implications for abandonment"],"prefix":"10.14814","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3796-6370","authenticated-orcid":false,"given":"Jean\u2010Charles","family":"Vauthier","sequence":"first","affiliation":[{"name":"D\u00e9partement de M\u00e9decine G\u00e9n\u00e9rale Facult\u00e9 de M\u00e9decine  Nancy France"},{"name":"D\u00e9partement of General Practice Maison de Sant\u00e9 des Trois Monts  Dommartin\u2010l\u00e8s\u2010Remiremont France"},{"name":"INTERPSY 5UR4432 Universit\u00e9 de Lorraine  Nnacy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlie","family":"Touze","sequence":"additional","affiliation":[{"name":"D\u00e9partement of General Practice Maison de Sant\u00e9 des Trois Monts  Dommartin\u2010l\u00e8s\u2010Remiremont France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Mauvieux","sequence":"additional","affiliation":[{"name":"UR 7480 VERTEX Universit\u00e9 de Caen  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corentin","family":"Hingrand","sequence":"additional","affiliation":[{"name":"UR 7480 VERTEX Universit\u00e9 de Caen  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre\u2010Louis","family":"Delaunay","sequence":"additional","affiliation":[{"name":"UR 7480 VERTEX Universit\u00e9 de Caen  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Besnard","sequence":"additional","affiliation":[{"name":"UR 7480 VERTEX Universit\u00e9 de Caen  Caen France"},{"name":"Service d'ORL Centre Hospitalier Universitaire de Caen  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Jouffroy","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Ambroise Par\u00e9 University Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, and Paris Saclay University  Boulogne France"},{"name":"IRMES \u2013 Institute for Research in Medicine and Epidemiology of Sport Institut National du Sport, de l'Expertise et de la Performance  Paris France"},{"name":"INSERM U\u20101018, Centre de recherche en Epid\u00e9miologie et Sant\u00e9 des Populations Centre de recherche en Epid\u00e9miologie et Sant\u00e9 des Populations, Paris Saclay University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Noirez","sequence":"additional","affiliation":[{"name":"Performance Sant\u00e9 M\u00e9trologie Soci\u00e9t\u00e9 (EA7507) Universit\u00e9 Reims Champagne Ardenne  Reims France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Maboudou","sequence":"additional","affiliation":[{"name":"Univ. 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