effect of 1600-meter run on changes in proteinuria

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EFFECT OF 1600-METER RUN ON CHANGES IN
PROTEINURIA, CREATININE AND HEMATURIA LEVELS
DURING RECOVERY TIME AMONG YOUNG FEMALE
ATHLETES AND NON-ATHLETES
Marzieh Arabpourian, Alireza Rahimi*, Amir Sarshin
College of Physical Education and Sports Science, Karaj Branch, Islamic Azad University,
karaj, Iran
*Corresponding Author: [email protected]
ABSTRACT
The purpose of this study was to evaluate the impact of 1600 running on
changes in albuminuria and creatinine level, urinary albumin to creatinine ratio
and hematuria level during recovery time among young female athletes and
non-athletes. The present research was an applied research and used semiexperimental methods. The research used a combination of intragroup and
intergroup designs. The research comprised 15 athletes and 30 non-athletes,
aged 18-22, 01 years. The number of subjects in this study was 20 students.
Urine samples were collected 3 times, before and after the test, performed with
an intensity of 70-80% of maximum heart rate after 1 minute. In order to
analyze the data, bifactor analysis of the variance was used, with one intragroup
factor, and one intragroup factor for variables of creatinine, and albuminuria
and urinary albumin to creatinine ratio. Also, Friedman test and Mann-Whitney
U test were used to check the intragroup and intergroup changes of hematuria,
respectively. All calculations were conducted at the significance level of 0.05
(alpha = 0.05). Results of this research: albuminuria in both groups significantly
increased following sports activities, but this increase was significantly greater
in the group of athletes in the group compared with a non-athletes. Creatinine
significantly increases in the athlete group, but its increase was not significant
in the non-athlete group. Urinary albumin to creatinine ratio was not affected by
the exercise in any of these two groups. Hematuria significantly increased
following exercise in both groups.
Conclusion: Proteinuria and hematuria formed due to exercise are not sign of
disease and kidney injuries, and they return to the initial level after a while, and
may not limit sports activities and are different from pathological conditions.
KEY WORDS: albuminuria, creatinine, hematuria
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INTRODUCTION
One of the factors contributing to the development of sports science is to obtain
better understanding body and it functions. Physical activities affect body
organs, and cause them adapt to specific requirements of organism during
physical activity. Muscles, heart, blood circulation, respiration and kidneys are
among organs which change following physical activity (Agha Alinezhad,
1994).
One of the organs that is studied in the fields of exercise and physiology is
kidney (Guyton, 2003).
Kidneys are vital organs of the various functions in the body. Kidneys play an
important and vital role in control of body fluids, osmotic pressure, electrolyte
content, and stability internal environment of the body. Thus, impaired kidney
function affects the function of almost all other body organs (Dilena, 1983).
Holding body nutrients and fluids and discharge of them through urine is
important, because almost all of glucose, amino acids and proteins are
reabsorbed by initial tubule before exiting tubular fluid. The process of
proactive reabsorption for glucose, amino acids and proteins is so strong that no
amount of such compounds usually enters the urine. In fact, exercise, fever, etc.
raise the level of waste matter from metabolism so high so that it exceeds the
ability of kidneys to discharge them (Guyton, 2008).
Among the important issues related to the kidney and urinary system are
proteinuria and hematuria which can be called sports proteinuria and hematuria
in sports science (Keller et al., 2007).
Proteinuria and hematuria are common in sports and during exercise. The
findings suggest that proteinuria occurs in sports that are performed with
intensity, while the intensity and duration of exercise can affect hematuria
(Bellingheiri et al., 2008) (Polito, 2005).
So we can say that these two disorders cause damage to the kidneys that may
affect its function.
Proteinuria
Healthy adults excrete about 100 to 150 mg of protein per day in the urine.
Excreting more than 100-150 milligrams of protein per day is called proteinuria
or urine protein, which condition is caused by different factors.
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Proteinuria is divided into two categories: transient and permanent.
Transient proteinuria: It is temporary and it appears to be a caused by fever,
heavy exercise, physical and mental stress, and exposure to extreme cold, in
which cases a relatively low amount of protein is excreted for a very short time.
Permanent proteinuria: It is permanent, and can be a sign of kidney disease or a
systemic disease. Many other diseases can also cause glomerulonephritis
(inflammation of the glomeruli) and eventually become proteinuria. These could
be diabetes, hypertension and other forms of kidney disease. Research has
shown that the degree and extent of proteinuria can show the extent of the
damage to the kidneys, and that proteinuria is also associated with
cardiovascular disease (Grigz, 2004).
Creatinine
Keratin is found in tissues rather in the form of keratin phosphate. Having lost
its phosphate root, keratin phosphate then becomes keratin. Keratin becomes
creatinine after losing a water molecule phosphate. Creatinine is in fact the
product of metabolism of keratin in muscles, and is excreted in the urine as
waste. Urinary reatinine level is a good factor to evaluate functioning of
kidneys. Creatinine is even larger than urea molecule and cannot penetrate the
membrane of tubules. Thus, almost no amount of creatinine is reabsorbed, and
creatinine filtered by the glomerulus is excreted in the urine. The amount of
creatinine in urine is an appropriate factor to assess how kidney is functioning.
A fixed amount of creatinine is excreted through urine in 24 hours, and does not
have to do with diet. Creatinine coefficient is the ratio between the amount of
creatinine excreted in 24 hours, and body weight in kilograms. Creatinine
coefficient 20-26 for healthy males, about 14-22 and for healthy women
(Guyton, 2012).
Creatinine excretion during exercise
Creatinine is a product of muscle creatinine. The daily production of creatinine
is proportional to the size of muscle mass. Also, muscle metabolism affects
urinary creatinine excretion rate. Higher creatinine excretion has been among
footballers after the match. Many factors affect urinary creatinine influence,
such as extreme sports, muscle injuries, as well as diabetes mellitus and low
hypothyroidism, which cause high protein and creatinine excretion (Newman,
2000).
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Hematuria
Determining the abnormal red blood cells in the urine depends on the
knowledge of the normal amount of red blood cells in the urine. Healthy
individuals may also have blood in their urine. Natural excretion of red blood
cells refers to urinary excretion of maximum 2 million RBC per day. The
condition in which 2-5 red book cells are present in each microscopic high
power field is called hematuria (Mousavi, 2010).
Hematuria is an alarm that cannot be ignored. Carcinoma of the kidney or
bladder stones and infections are among the causes of hematuria. Painful
urination is an important factor to be considered in clinical examination.
Hemoglobinuria, which is one of hemolytic syndromes, also cause red colored
urine (Gerin, 1999).
Sports hematuria
Presence of red blood cells in the urine is called hematuria. This phenomenon is
sometimes found in those involved in contact sports such as American football,
marathon and heavy sports. According to the results of researches, there are
several reasons for this: hemolysis of red blood cells (due to feet hitting the
ground), localized renal anemia, hypoxic damage to the kidneys, urine
myoglobin, peroxidation of red blood cells, excessive release of catecholamine,
increased production of free radicals, and raised body temperature (Ey-mich,
2001).
Also researches have been conducted on kidney injuries following some sports
activate. They have suggested that athletes usually develop benign hematuria.
The hematuria can originate in kidney, bladder, prostate and urethra. In heavy
contact exercises, intensity and type of contact determines the type of lesion,
with contact and martial sports most damaging kidneys. Such sports activities
can either directly cause kidney injuries or prepare conditions for kidney
injuries (Holmes, 2003).
Injuries that are formed following exercise are usually due to shaking of kidney
during long running or direct blows to kidney, which blows may damage renal
veins and consequently hematuria (Holes, 2003).
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Operational definitions of research terms
Proteinuria:
• Theoretical definition: Excretion of more than 100 to 150 milligrams of
protein per day. Healthy adults excrete about 100 to 150 mg of protein in urine
per day, which, of course, depends on the volume of urine; excretion of protein
above this level is called proteinuria (Bellinghieri, 2008).
Albumin:
• Theoretical definition: Albumin is a protein with a negative electrical charge,
molecular weight of 60,000 thousand Dalton, which makes up 54% of plasma
proteins and many parts of divalent ions in the plasma and the some plasma
hormones attach to this protein, and an important part of the plasma’s oncotic
pressure is due to the presence of this proteins. Due to the molecular size and
negative charge, quite a bit, that is, less than 40 mg of this substance is filtered
through the glomeruli per day. Any factor that causes a change in negative
charge of the glomerular basement membrane, or changes in kf "the
permeability of the glomerular basement" will increase the urinary excretion of
albumin (Dousti, 1996).
• Operational definition: The normal concentration of albumin in the urine of 24
hours is between 2-20 mg per day. Because the range of random normal
albuminuria is not defined, the albuminuria in this study refers to the rate of
change of albuminuria as measured by autoanalyzer Hitachi 902.
Creatinine:
• Theoretical definition: Keratin is found in tissues rather in the form of keratin
phosphate. Having lost its phosphate root, keratin phosphate then becomes
keratin. Keratin becomes creatinine after losing a water molecule phosphate.
Creatinine is in fact the product of metabolism of keratin in muscles, and is
excreted in the urine as waste. Urinary reatinine level is a good factor to
evaluate functioning of kidneys (Guyton, 2012).
• Operational definition: The normal concentration of creatinine in urine for
women is 20-320 milligrams per deciliter. The creatinine in this study refers to
its rate of change as measured by autoanalyzer Hitachi 902.
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Albumin to creatinine ratio:
• Theoretical definition: It is a functional ratio that is used in kidney functional
tests, to assess the damage to the glomeruli (Pagana, 2013).
• Operational definition: Normal microalbumin to creatinine concentration is
about 30 micrograms per milligram. If it higher than this range, it is indicative
of kidney injury and kidney disease.
Hematuria:
• Theoretical definition: It refers to observing 2 to 5 red cells in each
microscopic high-power field (HPF) in the urine of subjects in the lab (Jones et
al., 2001).
• Operational Definition: The hematuria in this study refers to presence of more
than 3 red blood cells in the urine of subjects in each microscopic high power
field, as measured by microscopy.
Female athletes:
• Operational definition: It refers to students who regularly participated in
training sessions of handball team at least 3 times a week during the past 1 year
and were members of handball team admitted to second grade women's league
of Iran.
Female non-athletes:
• Operational definition: It refers to students who have not participated in any
training program during the past 1 year.
Literature
Shavandi et al. (2012) studied the impact of exercise on urinary excretion of
gamma glutamyl transferase and protein among in elite female athletes, and the
results showed that a there was a significant difference between the amount of
urinary excretion of creatinine, protein and gamma glutamyl transferase in the
three-stage sampling.
Kohanpour et al. (2013) studied the acute and chronic effect of consecutive 8week strength exercise on albumin, protein, β2-microglobin, creatinine, and
urinary protein-to-creatinine ratio, and red blood cells in the urine of active
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young females. The results showed that the experimental group had higher
albuminuria, protein and β2-microglobin, compared with control group, while
the two groups were not significantly different in terms of urinary creatinine and
hematuria levels. Protein-to-creatinine ratio significantly increased in
experimental group.
Hajirasouli (2013) examined the blood in the urine (hematuria) in Iranian
boxers and runners, and the results showed that 27 of the 50 boxers had
macroscopic and microscopic hematuria and also the sprint and endurance
runners had hematuria.
Ayca et al. (2012) studied the effect of match on levels of gamma glutamyl
transferase, creatinine and protein among male and female taekwondo players.
The results showed that excretion of gamma glutamyl transferase, protein and
creatinine increased after match.
Fahad Saeed (2012) studies the relationship between urinary protein and sports,
and showed how one can make that one whose urinary protein level is high is a
runner rathen than a patient, studying the reasons behind the excretion of
protein in the urine.
Finally, Franchignoni et al. (2012) dicussed presence of blood in runners’ urine
after undergoing whole body vibration (WBV). In this research, they concluded
WBV can make the athlete unintentionally run the risk of hematuria. They
concluded that platforms that cause the body to undergo WBV can pose health
risk.
Research Hypotheses
This research, thus, studied the effect of 1600-run on albuminuria, urinary
creatinine levels and urinary albumin-to-creatinine ratio, after sports activity
and recovery time is different between young female athletes and non-athletes,
and the research hypotheses are as follows:
1- Effect of 1600-run on albuminuria level after sports activity and recovery
time is different between young female athletes and non-athletes.
2- Effect of 1600-run on urine creatinine after sports activity and recovery time
is different between young female athletes and non-athletes.
3- Effect of 1600-run on albumin-to-creatinine ratio after sports activity and
recovery time is different between young female athletes and non-athletes.
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4- Effect of 1600-run on hematuria after sports activity and recovery time is
different between young female athletes and non-athletes.
Methodology
This research was conducted using applied and semi-experimental method.
Statistical population comprised 15 athletes (a hand ball team from second
grade women’s league hand) and 30 non-athletes (students of university of art),
aged 18-22. Sample size was 20. Questionnaire was administered to two groups
of 10, one comprising athletes who were selected in a targeted manner, and the
other comprising non-athletes who were participated in this study voluntarily
upon signing the letter of consent, and were chosen by randomized method.
Tools
1. Hitachi AutoAnalyzer device (Hitachi 902), made in Japan
2. Pars Azmoon test kits, made in Iran
3. Olympus microscope, made in Japan
4. Randox kits, made in Northern Ireland
5. Stopwatch: Taksun, Ts-1809, made in China
6. Polar clock, made in China
Data analysis was carried out using descriptive and inferential statistics methods
(Mann - Whitney U-test, and Friedman test) and all calculations were conducted
using SPSS software version 20 at significance level of alpha= 0.05.
Procedure
Participants were asked to avoid eating a diet high in protein, fat and caffeine
the night before the test and a steady diet was provided. Participants came to the
gym an hour before the test. At the same time, they emptied their bladder. After
breakfast and away from any physical activity, they rested in a sitting position
for 30 minutes. The first sample was taken 5 minute before start of test, and the
second after the end of the test with intensity of 70-80% of maximum heart rate.
Third sample was taken after subjects rested for 60 minutes, while both groups
were administered with at least 200 ml of water, it was necessary to ensure the
lost fluid and urine were replenished.
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Results
Table 1.1 - The mean and standard deviation of individual specifications of subjects
such as age, weight, height, body mass index, record for 1600-meter run shown
separately for athletes and non-athletes
Group
Age (yrs.)
Weight
Height (cm) record
for Body
mass
(kg)
1600-meter run index
(s)
Athlete
± 1/49
± 7/02
± 6/96
10.85± 450.76 1.62 ±20.98
20/30
56/11
163/30
Nonathlete
± 1/33
± 4/45
± 7/02
494/00 ± 23/15 2.73± 21.05
20/00
57/63
166/40
Table 1-2 Mean and standard deviation for values of albumin, creatinine, urinary
albumin to creatinine ratio and the maximum value of hematuria in three measurement
steps including pre-test, immediately after the sports activity and recovery, shown
separately for the two research groups
Measurement steps
Immediately
Variable
Group
Pre-test
after the sports Recovery
activity
Albumin (mg / L)
Athlete
3/77 ± 0/47
7/36 ± 0/93
5/68 ± 0/88
Creatinine (mg / L)
Nonathlete
Athlete
3/23 ± 0/93
4/50 ± 0/57
3/66 ± 0/46
146/40 ± 9/67
265/80 ± 15/92 202/40 ± 12/83
Nonathlete
Urinary albumin to Athlete
creatinine ratio (g /
Nonmgμ)
athlete
123/00 ± 31/96 153/60 ± 33/17 123/10 ± 20/42
Hematuria (n)
9
25/75 ± 2/86
27/65 ± 2/94
28/10 ± 4/43
28/21 ± 9/93
30/03 ± 5/24
30/29 ± 5/22
Athlete
0/70 ± 0/67
6/70 ± 3/46
3/40 ± 0/03
Nonathlete
0/40 ± 0/52
4/50 ± 1/43
2/10 ± 0/74
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Table 1-4 Results of intragroup one-way analysis of variance of independent t-test with
post hoc tests and descriptive statistics of albuminuria levels (g/mgμ)
Results
from
Measurement steps
ANOVA
with
Group
Immediately
repeated
Pretest
Recovery
after activity
measurements
Athlete
3/77 ± 0/47
7/36 ± 0/93*†
± 0/88*†‡
5/68
F 2,18 = 279.479,
Sig = 0.000
Non-athlete
3/23 ± 0/93
4/50 ± 0/57†
3/66 ± 0/46‡
F 2,18 = 16.657,
Sig = 0.000
Results
from
t 18 = 2.088, t 18 = 8.239, t 18 = 6.438,
independent tSig = 0.051
Sig = 0.000
Sig = 0.000
test
* Significantly different from those of non-athletes at the same step of measurement (P
<0.01). † Significant difference pre-test results of the same group (P <0.01). ‡
Significantly different from step of immediately after sports activity (P <0.01).
Athlete
Albuminuri
a level
Non-athlete
Pre-test
After recovery
immediately after sports activity
Diagram 1-1 Comparison of two groups and three measurement steps in terms
of albuminuria
The results indicated that in both groups, albuminuria significantly increased
following sports activity (comparison of pre-test and immediately after activity
separately for each group). However, such increased was higher in athlete
group, compared with non-athlete group (comparison of values immediately
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after activity between two groups). Also, after recovery, albuminuria level
significantly reduced compared with albuminuria level after exercise. However,
it was still higher than pretest values in both groups. However, in non-athlete
group, after recovery time, albuminuria level reduced compared with
albuminuria level after exercise, and returned to the initial before-activity level.
The important point to note is that after recovery time, albuminuria level of
athlete group was significantly higher, compared with non-athlete group.
Table 1-4 Results of intragroup one-way analysis of variance of independent ttest with post hoc tests and descriptive statistics of creatinine levels (g/mgμ)
Results from
Measurement steps
ANOVA with
Group
Immediately
repeated
Pretest
Recovery
after activity
measurements
F
=
2,18
± 9/67
± 15/92*†
± 12/83*†‡
Athlete
328.247, Sig =
146/40
265/80
202/40
0.000
Non-athlete
± 31/96
123/00
153/60 ± 33/17 123/10 ± 20/42
F 2,18 = 4.892,
Sig = 0.020
Results
t 10.636 =
from
t 18 = 9.642, t 18 = 10.397,
2.216, Sig
independent
Sig = 0.000
Sig = 0.000
= 0.051
t-test
* Significantly different from those of non-athletes at the same step of
measurement (P <0.01). † Significant difference pre-test results of the same
group (P <0.01). ‡ Significantly different from step of immediately after sports
activity (P <0.01).
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Creatinine
level
Athlete
Nonathlete
Pre-test
After recovery
Immediately after sports activity
Diagram 1-1 Comparison of two groups and three measurement steps in terms
of creatinine
The results indicated that in both groups, creatinine significantly increased
following sports activity (comparison of pre-test and immediately after activity
separately for each group). Although results showed that creatinine level
significantly increased after exercise in athletes groups, such increase was not
statistically significant, and such increase was significantly more in athletes
group (comparison of after activity values between two groups). Also, after
recovery, creatinine level significantly reduced compared with creatinine level
after exercise. However, it was still higher than pretest values in both groups.
However, in non-athlete group, after recovery time, creatinine level reduced
compared with creatinine level after exercise, and returned to the initial beforeactivity level. Overall, 1600-meter run and recovery time had not a significant
effect on creatinine level immediately after activity and return of it to its initial
level. The important point to note is that after recovery time, creatinine level of
athlete group was significantly higher, compared with non-athlete group.
Table 1-5 Results of intragroup one-way analysis of variance of independent ttest with post hoc tests and descriptive statistics of urinary albumin to creatinine
ratios (g/mgμ)
Group
Measurement steps
Pretest
12
Immediately
activity
after
Recovery
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Athlete
25/75 ± 2/86
27/65 ± 2/94
28/10 ± 4/43
Nonathlete
28/21 ± 9/93
30/03 ± 5/24
30/29 ± 5/22
Athlete
Albuminuriato-creatinine
ratio
Nonathlete
Pre-test
After recovery Immediately after sports activity
between two groups and measurement steps in terms of urinary albumin to
creatinine ratio
The results showed that in both athletes and non-athletes groups, urinary
albumin to creatinine ratios slightly increased immediately after sports activity
and after recovery. However, there was no significant difference between two
groups and measurement steps in terms of such increase.
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Table 1-6 Results from Mann-Whitney U test and Friedman, along with
descriptive statistics related to the hematuria levels
Group Measurement steps
Results
Immediately after
Pre-test
Recovery
from
activity
Interquarti
Interquarti
Interquarti Friedm
Media
Media
Media
an test
le
le
le
n
n
n
deviation
deviation
deviation
Athlete
χ2 (df=2)
=
1/00
0/500
5/00
1/375
3/00
0/750
20.000,
*Sig =
0.000
Nonχ2 (df=2)
athlete
=
0/00
0/500
5/00
1/00
2/00
0/625
19.000,
*Sig =
0.000
Results
from
w = 93.00,
w = 84.00,
w = 86.00,
MannZ = -1.023, Sig = Z = -1.744, Sig = Z = -1.481, Sig =
Whitne
0.306
0.081
0.139
y
U
test
* significant difference at alpha = 0.01
Table 1-7 The results of post hoc tests (Wilcoxon) for the Friedman test for
haematuria values in three measurement steps
Group
Effect
Measurem Wilcoxon signed-rank test
ent steps
Athlete
Effect of sports 1st
2nd
*T = 0.00, Z = -2.818 sig =
activity
0.005
st
rd
1
3
*T = 0.00, Z = -2.844 sig =
0.004
Recovery
nd
rd
2
3
*T = 0.00, Z = -2.814 sig =
0.005
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Nonathlete
ISSN: 1298-0595
Effect of sports 1st
activity
1st
2nd
Recovery
3rd
2nd
3rd
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*T = 0.00, Z = -2.823 sig =
0.005
*T = 0.00, Z = -2.701 sig =
0.007
T = 0.00, Z = -2.724 sig =
0.006*
* significant difference at alpha = 0.01
Athlete
hematuria
Nonathlete
Pre-test
After recovery immediately after sports activity
Diagram 1-1 Comparison of two groups and three measurement steps in terms
of hematuria
The overall results indicated that the two groups were not significantly different
in in any of the measurements steps. Although results showed that hematuria
level significantly increased after exercise in athletes groups, such increase was
not statistically significant. Also, after recovery, hematuria level significantly
reduced compared with hematuria level after exercise. However, it was still
higher than pretest values in both groups. Thus, it can be said that exercise and
recovery affected hematuria level in both groups, but such effect was not
different between two groups.
Conclusions
1- As for the first hypothesis (effect of 1600-run on albuminuria level after
sports activity and recovery time is different between young female athletes and
non-athletes);
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The results showed that effect of 1600-run on albuminuria level was different
between two groups in the three measurement steps between athletes and nonathletes groups, and difference between the two groups was significant.
The results was consistent with Alijani et al. (2009), Sarhaddi (2009), Afshar et
al. (2008), Gaini et al. (2011), Kohanpour et al. (2012), Shavandi et al. (2012),
Kohanpour et al. (2013), Al Ates et al. (2000), John et al. (2000), Jonse et al.
(2001), Montelpare et al. (2002), Gerth et al. (2002), Labilloy et al. (2004),
Sentruk et al. (2007), Ayca et al. (2008), Bellinghieri et al. (2008), Demir et al.
(2009), Ghieda et al. (2011), Ayca et al. (2012), Fahad Saeed et al. (2012).
The results were inconsistent with Rafatipour et al. (2012) and Babaei et al.
(2012).
Thus, sports activity affect the functioning of kidneys. Reduced blood acidity
increases permeability of glomerular membrane, in other words, free hydrogen
ions from lactic acid can bind to carboxyl of glomerular capillary wall, resulting
in destruction of its limiter charge, which in turn results in passage of protein
molecule through this membrane. In fact, increased lactic acid level after
exercise results in heavy protein molecules such as albumin and light protein
molecules are found in urine alike. Also, by preventing tubular reabsorption of
light protein molecules, it causes such proteins to be found in urine. Another
important factor in constriction of blood vessels during exercise due to
functioning of sympathetic nervous system, which results in increased
glomerular filtration of protein.
Thus, although both group had significant proteinuria, its level was significantly
higher in athlete group, which can be explained by the fact that athletes
performed the sports activity with a higher intensity and during a shorter time.
As a result, Renin-angiotensin system, catecholamines are activated, and finally,
hemodynamic properties of kidney are reduced. After the release of renin,
Angiotensin II increases and glomerular transport pressure, through filtration
fraction, results in severe narrowing of efferent and afferent vessels.
However, urinary protein formed following sports activity is not a symptom of
kidney injury and disease, and disappears after a while and can not restrict
activity and so is different from pathological conditions.
2- As for the second hypothesis (effect of 1600-run on creatinine level after
sports activity and recovery time is different between young female athletes and
non-athletes);
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The results showed that effect of 1600-run on creatinine level was different
between two groups in the three measurement steps between athletes and nonathletes groups, and difference between the two groups was significant.
The results was consistent with Sarhaddi (2009), Gaini et al. (2011), Babaei et
al. (2012), Kohanpour et al. (2013), Ayca et al. (2008), Calabria et al. (2009),
Ayca et al. (2012).
Also, the results for soccer players and substitutes obtained by John et al. (2000)
were consistent with results obtained in this research for female athletes and
non-athletes, respectively.
Thus, formation of creatinine in the body is the result muscle activity that is
directly related to the amount of body muscles. During increased muscle
activity or any disorder that leads to destruction of muscle and increased muscle
metabolism, creatinine production will increase. Following increased
production of creatinine, creatinine excretion must increase to maintain the level
of serum creatinine and this will lead to increased urinary creatinine.
Thus, in this research, although creatinine level increased in both groups, it was
only significant in athletes group, which can be explained by the fact that
atheletes have more mascle mass, compared with non-athletes, and performed
activity with higher intensity and during a shorter time, and therefore, their
metabolism increased more. Also, physical hitting of the foot to the ground
results in destruction of cell tissue, thus resulting in increased urinary creatinine.
On the other hand, frequent exercises results in micro injuries to be formed in
the organs of athletes, which can increase urinary creatinine.
3- As for the third hypothesis (effect of 1600-run on urinary albumin to
creatinine ratio after sports activity and recovery time is different between
young female athletes and non-athletes);
The results showed that effect of 1600-run on urinary albumin to creatinine ratio
was not different between two groups in the three measurement steps between
athletes and non-athletes groups, and difference between the two groups was not
significant.
These results were consistent with Rafatifard et al. (2012) and Babaei et al.
(2012).
The results were inconsistent with Kohanpour et al. (2013).
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Thus the results showed urinary albumin to creatinine ratio slightly increased
immediately after exercise and after recovery time elapsed in both groups.
However, such increase was not different between the two groups and the
measurement steps, which indicated intensity and type of exercise were not
associated with kidney injury.
4- As for the third hypothesis (effect of 1600-run on urinary hematuria after
sports activity and recovery time is different between young female athletes and
non-athletes);
The results showed 1600-run had an effect on urinary hematuria in the two, but
there was no difference between the two groups in terms of this effect.
The results were consistent with Alijani et al. (2009), Bob al-Haeji et al. (2007),
Kohanpour et al. (2013), Hajrasouli (2013), Al Ates et al. (2000), Jones et al.
(2001), Gerth et al. (2002), Otama et al. (2004), Polito et al. (2005), Pani and
Mowla (2007), Bellinghieri et al. (2008), Demir et al. (2009), Ghieda et al.
(2011) and Franchignoni et al. (2012).
The results were inconsistent with Sarhaddi (2009) and Kohanpour (2012).
Thus, in this research that studied the effect of run among athlete and nonathlete girls, the results suggested that there was no significant difference
between the two groups in any step of measurement. However, the results
showed that in both groups, hematuria level significantly increased due to sports
activity. Although hematuria level was higher in athletes group after sports
activity and recovery time, compared with non-athlete group, such difference
was not statistically significant.
Suggestions
Because the amount of excreted albumin significantly increased in both groups
in the study, especially in athletes, and mechanism of protein excretion shows
that intense activity has an effect on the glomerular membrane and cause
urinary albumin and also hematuria, which in this study was significant in both
groups, and hematuria or blood in the urine, which in this study was significant
in both groups, and that following intense exercise, due to hemolysis of red
blood cells and hypoxia and increases the concentration of lactic acid, which
creates acidosis, cause erythrocytes to pass into the urine because of the
increased glomerular permeability, therefore, both of these factors may cause
serious damage to the kidneys in long term; accordingly, the instructors are
advised to are aware of the intensity of exercise, and set it so that less
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proteinuria and hematuria are excreted, and given recovery time in the study
was set to one hour, although after this time, a significant reduction in excretion
of these factors occurred, it is still higher than the base case, and therefore, it is
recommended that educators choose rest time considering the time and intensity
of the activity, so that the body recovers and excessive pressure is not imposed
on kidneys; also, the athletes who train for many years must be under
supervision by physician and undergo periodic examinations to prevent future
problems.
References
1- Aqaalinezhad, H. (1994), Comparison of total urinary protein excretion, beta-2
microglobulin, creatinine, sodium and potassium levels following activity at 75%
of peak aerobic power among male student athletes and non-athletes, MS Thesis,
The University of Tehran.
2- Ey-Mitch, W. (2001), Nutrition and kidney, translated by Mazraati, A., Nasl no
andish press.
3- Babaei, R. et al. (2012), The effects of motion and intensity of physical activity on
the amount and type of exercise proteinuria in active young men, Journal of
Family Health. School of Medical Sciences, Islamic Azad University, Sari
Branch, Volume 1, No. 1, pp. 18- 24.
4- Pagana, K., Pagana, T. (2013), A comprehensive book of diagnostic and
laboratory tests of Pagana, translated by Salahi M., Jafari press.
5- Dusti, M. (1996), Medical biochemistry, The University of Tehran press, third
edition.
6- Rafatifard, M. et al. (2012), The effect of 8 weeks of running on the treadmill on
7- blood pressure and urinary excretion of albumin in patients with chronic renal
failure, Journal of Medical Sciences Univeristy of Army of the Islamic Republic
of Iran, No. 2, pp. 118-124.
8- Sarhaddi, M. (2009), The influence of karate tournament-caused pressure on the
total urinary excretion of creatinine, sodium, calcium, glucose, and hematuria in
the elite women, MS thesis, Department of Physical Education, Islamic Azad
University, Karaj Branch.
9- Alijani, A., Khodayari, B., (2009), The impact of sprint and endurance running on
the level of hematuria and proteinuria among male runners aged 15-18, Islamic
Azad University, Karaj Branch, Journal of Sport Sciences, No. 1, pp. 29-30.
10- Gaeini, A. et al. (2011), Comparison of urinary protein excretion caused by two
types of protocol, semi-soccer, and official soccer, Journal of metabolism and
sports activity, No. 2, p. 15.
11- Guyton and Hall (2012), Guyton and Hall Textbook of Medical Physiology,
translated by Sepehri, H. et al., Andisheh rafi press, fourth edition.
19
EPHEMERA
http://ephemerajournal.com/
ISSN: 1298-0595
Vol.27; No.1 (2015)
12- Guyton, A. (2008), Medical Physiology, translated by Bigdeli, M., Teimourzadeh
press, second edition.
13- GrIgz, A. (2004), kidney disease, translated by Rajabi, B., Teimourzadeh press.
14- Gerin, W. (1999), Clinical Physiology, translated by Sadeghi Loyeh, A., Farda
press, eleventh edition
15- Mousavi, M., (2010), Effects of continuous and intermittent exercise on hematuria
and proteinuria in untrained young girls, MS Thesis, Islamic Azad University,
Karaj Branch.
16- Afshar, R., S. Sanavi and M.A. Fakharian. (2008).The pattern of proteinuria
following karate (kumite) competitions. NDT plus, 5: 376.
17- Al Ates Mehmet Kilic, Selda Kilic. (2000) Sport dependent proteinuria and
hematuria in football players. Say 17, 55-57 konaya
18- 3- Ayca, Banu.Sener, Aziz. Rabia,Oba. Ramazanoglu,Nusret.(2012).The effect of
competition on Gamma-glutamy1 transferase,creatinine and protein levels of
taekwondo players. Academic Journals. 6(20), 1462-1468.
19- Ayca,Banu.Sener,Aziz.Rabia,Oba.Pastirmaci,G.(2008).Evaluation of Gammaglutamy1 transferase changing in urine related to the training ioad in the rhythmic
gymnasts competitors aged 7-10,biology of sport.25,3.
20- Babalhavaeji, Hooshang, MD. Mosavi Bahar, Seyed Habibollah ,MD. Imami
,Farzad MD and Amir Zargar,Mohammad Ali MD.(2007). Evaluation of PostExercise Test Hematuria in Hamadan, Iran.Iranian Heart Journal; 8 (3): 32-35.
21- Bellinghieri, G., V. Savica and D. Santoro, (2008). Renal , alterations during
exercise. J. Ren. Nutr., 18: 158-164.
22- Calabria Baxmann,Alessandra.et al.(2008).Influene of Muscle Mass and Physical
Activity on Serum and Urinary Creatinine and Serum Cystatin C.Clin J Am Soc
Nephrol 3:348-354.
23- Demir, Nihat, MSc, Bayazit, Vahdettin, PhD Baltac‎, Abdulkerim Kas‎m, PhD.
(2009). The Evaluation of Inspirations Parameters, Hematuria and Proteinuria
Concenterations of Different Countries’ National Team Boxers. Australian
Journal of Basic and Applied Sciences, 3(2):1004-1012
24- Dilena BA.(1983).six method for determination urinary Protein compared.Clinical
Chemistry. 29(3):553-557.
25- Fahad, Saeed, MD;Pardha Naga Pavan;Kumar Devaki, MD;Lokesh
Mahendrakar,MD; Jean L. Holley, MD.(2012).Exercise-induced proteinuria? The
Journal of Fa mily Practice . Vol 61, No 1.
26- Franchignoni. F,Vercelli. S., Özçakar. L.(2012). Hematuria in a runner after
treatment with whole body vibration: A case report. Scand J Med Sci Sports 2012:
••: ••–••. doi: 10.11 11/j.1600-0838.2012.01478.x
27- Hajirasouli, Masoud.(2013). Evaluation of hematuria in Iranian boxers and
runners International Journal of Biosciences | IJB |. Vol. 3, No. 5, p. 149-155,
20
EPHEMERA
http://ephemerajournal.com/
ISSN: 1298-0595
Vol.27; No.1 (2015)
28- Gerth J,Bartsch R and Hubscher J(2002).The effect of prolonged physical exercise
on renal function.European journal of applied physiology .vol.86,pp196202(42ref)
29- Ghieda ,Y Mohamed ,Shereen M.Samir and Nancy A. Ahmed(2011). Effect of
sport Exercises on kidney. World Journal of Sport Sciences 5(2) : 107-111.
30- Holes,David and Jackie Butter.(2004 ).Anatomy and physiology .774-785
31- Holmes FC,Hunt JJ.(2003 ).Renal injurol sport .Curr sport Med Rep.2 (2):103109.
32- 17- Jane F.(2000).Urinary protein and albumin excretion corrected by creatinine
and specific gravity,volume,224-1-2.
33- Jones, GR,Newhouse IJ,Jakobi JM,Lavoie NL,Thayer R. (2001 ),The incidence of
hematuria in middle distance track running.Apple physiol 26(4).336-349.
34- Keller,B; Ghani,KR;Nargund,V.(2007). Hematuria:
evaluation and laborator investigations. 68(8):418-422.
risk
factors,cilinical
35- Kohanpour ,Mohammad Ali , et al.(2013). Effect of Eight Weeks Intermittent
Resistance Trainings on Excretions of Urinary Proteins in Rest Time and in
Response to one Turn of Resistance Sport in Active Young Women. J. Appl.
Environ. Biol. Sci., 3(5)17-26, 2013
36- Kohanpour ,Mohammad Ali , et al.(2012). Effect of Submaximal Aerobic
Exercise in Hypoxic Conditions on Proteinuria and Hematuria in Physically
Trained Young Men. Iranian Journal of Kidney Diseases. Volume 6:192-7
37- Kohanpour ,Mohammad Ali , et al.(2012). Effect of a Karate Competition on
Urinary Excretion of Proteins with High Molecular Weight (Glomerular
proteinuria) in Young Male Karatekas. Current Research Journal of Biological
Sciences 4(6): 660-664.
38- Labilloy,D.Et al.(2004).The work in density on exercise proteinuria springer
berlin Teid berg.57-3-3.
39- Montelpare,WJ,Klentrou,P,and Thoden,J.(2002).Continous versus intermittent
exercise effect on urinary excertion of albumin and total protein.Journal of science
and medicine in sport 5 (3):219-228.
40- New man.D avid.michaer,J.(2000 ).wrinary protein and albumin exvertion
corrected by creatinine and specific gravity.Department of pathology .the ohio
state university medical center 294,1-2,139.
41- Otama ,ozonos and etal.(2004 ).Analysis of sports hematuria after running in
summer.Nippon Hhnyokika Gakkaizasshi.95(5 );705-710.
42- Pani.A;Mowla, A.(2007). can exercise cause hematuria in children?. Circulation
journal Vol 71 supp 1 I.
43- Polito,C.(2005).sport hematuria in boys after matches football springier-heidel
bery,20-28.
21
EPHEMERA
http://ephemerajournal.com/
ISSN: 1298-0595
Vol.27; No.1 (2015)
44- Senturk, U.K., O. Kuru., G. Kocer and F. Gunduz,(2007). Biphasic pattern of
exercise-induced proteinuria in sedentary and trained men. Nephron Physiol, 105:
22-32.
45- Shavandi, Nader PhD; Samiei, Abolfazl, MSc; Afshar ,Reza, MD; Saremi
,Abbas, PhD; Sheikhhosein,Rahman i, MSc.(2012). The Effect of Exercise on
Urinary Gamma-Glutamyltransferase and Protein Levels in Elite Female Karate
Athletes. Asian Journal of Sports Medicine, Volume 3 (1), Pages: 41-4
22