{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T08:07:40Z","timestamp":1758701260221,"version":"3.44.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Background\/Objective<\/jats:title><jats:p>Athletes have commonly reported hematuria, cylindruria, and proteinuria, which are consistent with \u201cathletic pseudonephritis.\u201d To date, little is known about the overall consequences of 100 km (62.5-mile) cross-country ultra-marathons on Asian male runners. This study aimed to examine (i) acute urinary changes in runners with athletic pseudonephritis following a 100 km cross-country ultra-marathon and (ii) whether this phenomenon is associated with the runners average running speed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty male Taiwanese ultra-marathoners were prospectively recruited. Urinary parameters were analyzed before and immediately after the 2020 Taiwania 100 K Ultra Trail. Competitors ran on a rugged forest path and the official cut-off time was 15 h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants showed a statistically significant post-race increase (p &amp;lt; 0.001) in urinary red blood cell counts. No significant difference was noted in urinary cast in the immediate post-race values compared to the pre-race values (p = 0.488). Urinary chemistry showed statistically significant increases in specific gravity (p &amp;lt; 0.001), osmolality (p &amp;lt; 0.001), creatinine (p = 0.027), microalbumin (p &amp;lt; 0.001), protein (p &amp;lt; 0.001), and myoglobin (p &amp;lt; 0.001) between the pre- and post-race values. Additionally, 10 (50%) post-race specimens had albumin-to-creatinine ratios &amp;gt;30 mg\/g, and 9 (45%) specimens showed protein-to-creatinine ratios &amp;gt;0.2 mg\/mg. The association between running speed and red blood cells in urine showed a p-value of 0.368. There were no correlations between running speed and changes in albumin-to-creatinine ratio (rs = \u22120.105, p = 0.661), protein-to-creatinine ratio (rs = \u22120.013, p = 0.957), or myoglobin (rs = 0.003, p = 0.99) levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Exercise-related hematuria and proteinuria were frequently observed in the Asian male cross-country ultra-marathoners. A faster running speed was not associated with the degree of exercise-induced hematuria, proteinuria or myoglobinuria.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2025.1608584","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T05:33:42Z","timestamp":1755149622000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Athletic pseudonephritis in male cross-country ultra-marathoners: a comparative observational study"],"prefix":"10.3389","volume":"16","author":[{"given":"Kai-Hung","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hsun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pang-Yen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Hua","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chorng-Kuang","family":"How","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-Kuang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hui","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng-Lin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Fong","family":"Kao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Kun","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ding-Kuo","family":"Chien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Han","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1016\/s0022-5347(17)40125-x","article-title":"Sports hematuria","volume":"143","author":"Abarbanel","year":"1990","journal-title":"J. Urol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1177\/036354658701500615","article-title":"Hematuria and microalbuminuria after a 100 kilometer race","volume":"15","author":"Alvarez","year":"1987","journal-title":"Am. J. Sports Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1097\/ju.0000000000001297","article-title":"Microhematuria: AUA\/SUFU guideline","volume":"204","author":"Barocas","year":"2020","journal-title":"J. Urol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1053\/j.jrn.2007.10.031","article-title":"Renal alterations during exercise","volume":"18","author":"Bellinghieri","year":"2008","journal-title":"J. Ren. Nutr."},{"key":"B5","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1056\/NEJMra0801327","article-title":"Rhabdomyolysis and acute kidney injury","volume":"361","author":"Bosch","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"s1471","DOI":"10.1515\/cclm-2015-0480","article-title":"Cylindruria","volume":"53","author":"Caleffi","year":"2015","journal-title":"Clin. Chem. Lab. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"c145","DOI":"10.1159\/000166605","article-title":"Urinary sediment cast scoring index for acute kidney injury: a pilot study","volume":"110","author":"Chawla","year":"2008","journal-title":"Nephron Clin. Pract."},{"key":"B8","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.jcma.2014.09.004","article-title":"Early changes of the anemia phenomenon in Male 100-km ultramarathoners","volume":"78","author":"Chiu","year":"2015","journal-title":"J. Chin. Med. Assoc."},{"key":"B9","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1001\/jama.286.6.714","article-title":"Runner's anemia","volume":"286","author":"Dang","year":"2001","journal-title":"Jama"},{"key":"B10","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1111\/j.1523-1755.2004.09201.x","article-title":"Albuminuria, not only a cardiovascular\/renal risk marker, but also a target for treatment?","volume":"66","author":"de Zeeuw","year":"2004","journal-title":"Kidney Int. Suppl."},{"key":"B11","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1186\/s12882-020-01948-w","article-title":"Association of single measurement of dipstick proteinuria with physical performance of military males: the CHIEF study","volume":"21","author":"Fan","year":"2020","journal-title":"BMC Nephrol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"545","DOI":"10.3109\/00365518009091962","article-title":"Excretion of casts and uromucoid in urine after prolonged heavy exercise","volume":"40","author":"Haugen","year":"1980","journal-title":"Scand. J. Clin. Lab. Invest."},{"key":"B13","doi-asserted-by":"publisher","first-page":"E261","DOI":"10.25011\/cim.v32i4.6616","article-title":"Prevalence and duration of exercise induced albuminuria in healthy people","volume":"32","author":"Heathcote","year":"2009","journal-title":"Clin. Invest. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1159\/000187290","article-title":"Urinary changes in ultra long-distance marathon runners","volume":"64","author":"Kallmeyer","year":"1993","journal-title":"Nephron"},{"key":"B15","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1080\/10408363.2020.1723487","article-title":"Diagnostic utility of protein to creatinine ratio (P\/C ratio) in spot urine sample within routine clinical practice","volume":"57","author":"Kami\u0144ska","year":"2020","journal-title":"Crit. Rev. Clin. Lab. Sci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1080\/00913847.2020.1782153","article-title":"Proteinuria in a high-altitude 161-km (100-mile) ultramarathon","volume":"49","author":"Khodaee","year":"2021","journal-title":"Phys. Sportsmed."},{"key":"B17","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1146\/annurev.me.33.020182.002251","article-title":"Rhabdomyolysis and myoglobinuria","volume":"33","author":"Knochel","year":"1982","journal-title":"Annu. Rev. Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s004210050480","article-title":"The effect of exercise intensity on hematuria in healthy male runners","volume":"79","author":"McInnis","year":"1998","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"93","DOI":"10.2165\/00007256-198806020-00004","article-title":"Rhabdomyolysis, myoglobinuria and exercise","volume":"6","author":"Milne","year":"1988","journal-title":"Sports Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1007\/bf02330700","article-title":"Renal protein excretion after exercise in man","volume":"58","author":"Poortmans","year":"1989","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1007\/s004210050217","article-title":"Evidence of differential renal dysfunctions during exercise in men","volume":"76","author":"Poortmans","year":"1997","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"562","DOI":"10.3390\/medicina56110562","article-title":"Proteinuria and bilirubinuria as potential risk indicators of acute kidney injury during running in outpatient settings","volume":"56","author":"Rojas-Valverde","year":"2020","journal-title":"Med. Kaunas."},{"key":"B23","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1080\/17461391.2020.1746837","article-title":"Exertional rhabdomyolysis and acute kidney injury in endurance sports: a systematic review","volume":"21","author":"Rojas-Valverde","year":"2021","journal-title":"Eur. J. Sport Sci."},{"key":"B24","first-page":"23","article-title":"Exercise-induced proteinuria?","volume":"61","author":"Saeed","year":"2012","journal-title":"J. Fam. Pract."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e000151","DOI":"10.1136\/bmjsem-2016-000151","article-title":"Exertional rhabdomyolysis: physiological response or manifestation of an underlying myopathy?","volume":"2","author":"Scalco","year":"2016","journal-title":"BMJ Open Sport Exerc Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/jsa.0000000000000198","article-title":"Participation trends of ultra endurance events","volume":"27","author":"Scheer","year":"2019","journal-title":"Sports Med. Arthrosc. Rev."},{"key":"B27","first-page":"1060","article-title":"Exercise proteinuria and hematuria: current knowledge and future directions","volume":"56","author":"Shephard","year":"2016","journal-title":"J. Sports Med. Phys. Fit."},{"key":"B28","doi-asserted-by":"publisher","first-page":"16887","DOI":"10.3390\/ijerph192416887","article-title":"Ultra-endurance participation and acute kidney injury: a narrative review","volume":"19","author":"Tidmas","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B29","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1123\/pes.25.3.360","article-title":"Pseudonephritis is associated with high urinary osmolality and high specific gravity in adolescent soccer players","volume":"25","author":"Van Biervliet","year":"2013","journal-title":"Pediatr. Exerc Sci."},{"key":"B30","doi-asserted-by":"publisher","first-page":"701","DOI":"10.3109\/0886022x.2014.890011","article-title":"Post exertional hematuria","volume":"36","author":"Varma","year":"2014","journal-title":"Ren. Fail"},{"key":"B31","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1002\/mus.10053","article-title":"Rhabdomyolysis: a review","volume":"25","author":"Warren","year":"2002","journal-title":"Muscle Nerve"},{"key":"B32","doi-asserted-by":"publisher","first-page":"33","DOI":"10.5114\/biolsport.2020.89939","article-title":"Factors influencing post-exercise proteinuria after marathon and ultramarathon races","volume":"37","author":"Wo\u0142yniec","year":"2020","journal-title":"Biol. Sport"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1608584\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T05:33:43Z","timestamp":1755149623000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1608584\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,14]]},"references-count":32,"alternative-id":["10.3389\/fphys.2025.1608584"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2025.1608584","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,14]]},"article-number":"1608584"}}