What All Runners With Kidneys Need to Hear: Dr Sherry Mansour and Dr F Perry Wilson

How many marathon runners have acute kidney damage after they cross the finish line? According to a Yale University study, the answer is a shocking 55%. So if you've ever run a marathon, the odds are slightly better than 50% that this has happened to you. But don't worry. The damage tends to be temporary, resolving itself after a few days. So we heal, get stronger, and move on. But what if something goes wrong? Dr. Sherry Mansour and Dr. F. Perry Wilson are kidney doctors or nephrologists at Yale, and they share their expertise on running and your kidneys. Dr. Mansour actually led the research on marathon runners and kidney research. They talk to Coach Claire about who is susceptible to acute kidney damage from running, what we can do about it, and what we still need to learn. They also discuss ibuprofen which can cause kidney issues, and how it can be used safely by runners. They also delve into kidney stones. If you've ever had one, you know they are extremely painful. They cover how to minimize the risk of kidney stones and what precautions kidney stone sufferers need to take when running long distances. If you are a runner with kidneys, this is one conversation you don't want to miss! Dr. Sherry Mansour grew up and attended medical school in New York. She graduated in 2010 and received the Highest Academic Achievement Award. She was elected valedictorian of her class and was also inducted into the Psi Sigma Alpha National Osteopathic Scholastic Honor Society. She went on to complete residency training in Internal Medicine at Stony Brook University Medical Center, where she was chosen as chief medical resident. She was inducted into the Alpha Omega Alpha Honor Medical Society, Stony Brook Chapter in 2012. She then joined Yale New Haven Hospital in 2014 as a Clinical Research Nephrology fellow. She also completed her Master of Science from the Yale School of Public Health in 2019 with a focus on Chronic Disease Epidemiology. Since her arrival at Yale, Dr. Mansour has been working on identifying novel repair biomarkers in blood and urine to better predict long-term kidney and heart disease outcomes after AKI, and improve overall patient care. Her K-23 proposal is focused on understanding the role of a vessel repair pathway, known as the Angiopoietin pathway, in graft outcomes after deceased donor kidney transplantation. A link to Dr. Mansour's full biography including links to her research and publications is: Yale Medicine Profile - Dr Sherry Mansour Dr. Wilson grew up in Connecticut, before attending Harvard College where he graduated with honors in biochemistry. He then attended medical school at Columbia College of Physicians and Surgeons, before completing his internship, residency, and fellowship at the University of Pennsylvania. In 2012, he received a Masters degree in Clinical Epidemiology, which has informed his research ever since. At Yale since 2014, his goal is using patient-level data and advanced analytics to personalize medicine to each individual patient. He is the creator of the popular online course "Understanding Medical Research: Your Facebook Friend Is Wrong" on the Coursera platform. A link to Dr. Mansour's full biography including links to his research and publications is: Yale Medicine Profile - Dr F Perry Wilson Questions Dr. Mansour and Dr. Wilson are asked: 6:33 Dr Mansour, you did a study a couple years ago at Yale that studied the effects of marathon running on the kidneys. Can you explain how the study was conducted and what you found? 7:50 So marathon runners have markers like people in the ICU. That sounds horrible. Should we be worried? 8:31 Why do runners suffer from Acute Kidney Injury? Is it unique to running? Do swimmers suffer from this too? 9:23 Sherry, you said that you just run for fitness, so I assumed you would be a marathon runner since you studied the effects of marathon running on kidneys. Can you tell me why you chose to study marathon runners? 10:38 Perry, are you a marathon runner? 10:48 Perry, what questions do you have when it comes to kidneys and running? Have you experienced dehydration? Have you tested your own urine after a race? 12:13 What role does dehydration, your sweat rate, and sodium play into the types of injuries that the kidneys have after endurance racing? 14:28 It's very difficult and actually not advised to drink the same amount of fluid that you actually lose during a race. What kind of advice would you give for somebody who says, "I know I sweat a lot. How much do I drink? How much salt do I put in my water?" Are these questions that you've been able to figure out yet? 16:28 Runners, especially older runners, worry about salt because their doctors say they shouldn't intake a lot of salt if they have high blood pressure. Or if they have other kidney problems, they might have been advised to be on a low salt diet. How does that play into while you're exercising? Should you continue to not consume much salt just because you're supposed to be on a low salt diet? 17:46 Runners hear a lot about ibuprofen. A lot of people call it Vitamin I and take it when they're feeling sore. Some people even take it before a race so they won't feel sore, and we as coaches try to advise against this. Can you talk about the link between ibuprofen and kidney injury? 22:08 One of the reasons I wanted to have both of you on the show is because I recently suffered from a kidney stone, something I haven't talked about until today. I'm a healthy, athletic person and did not expect it. It was the worst pain of my life and as an athlete, I'm struggling to find good advice for hydration for kidney stone sufferers. Perry, can you give me some advice? 25:00 Through my research I've found that kidney stones are fairly common. Is that correct? 25:16 What do kidney stone sufferers have to do as far as exercise goes? I'm absolutely dehydrated at the end of a marathon. Is that more dangerous for me than it would be for someone who doesn't have a kidney stone history? 26:59 I haven't heard of people talking about how endurance runners and kidney stones interrelates at all, so I think there's a lot of people out there that are hungry for this advice. Like I said, that's why I want to have you guys on the show. So we can still run, we can still get a little dehydrated, but our risk is going to be a little higher is what you're saying? 28:21 I think most runners now take Tylenol instead of ibuprofen, which hurts our liver instead of our kidneys. There's also some evidence that Tylenol actually affects your brain and makes your perception of effort go down. So any time there's something like that, runners are like, "Give it to me. Give it to me." 29:25 Acute Kidney Injury from marathon running is typically temporary. When do we have to worry that something could be wrong and damage could become chronic? 31:17 Have you looked at people who you measured right after the race and then looked at them a few days later to see if the damage was resolved? 32:15 If you could go back and talk to yourself when you started running, what advice would you give? 33:41 Where can listeners connect with you? 34:12 Do you know why students at Yale aren't allowed to run outside? Quotes by Dr. Mansour and Dr. Wilson: "This urine really we see in the hospital all the time when patients are in the ICU when their blood pressure is really low so we didn't think that we would see something similar in runners but that was sort of the main finding that kind of surprised us." (Dr. Mansour) "I wish I were a runner. Every time I do studies with marathon runners, they're so inspiring, they're so dedicated. It's really a great crowd to be around, but I'm just not like that. I don't have the stamina." (Dr. Mansour) "There might not be that much of a correlation between how you feel and what's going on in your kidneys because I was convinced I was going to see the most terrible stuff based on how I was feeling at the end of that race and my kidneys kind of shrugged it off." (Dr. Wilson) "A kidney stone is painful but it isn't going to kill you either, so you have to think about the benefits." (Dr. Wilson) Take a Listen on Your Next Run Leave a space for libsyn link Want more awesome interviews and advice? Subscribe to our iTunes channel Mentioned in this podcast: Article: Marathons and Kidney Damage: What Runners Should Know Runners Connect Winner's Circle Facebook Community RunnersConnect Facebook page RunnersConnect Focus Classes email Coach Claire Follow Drs. Mansour and Wilson on: Dr. Mansour on Twitter Dr. F Perry Wilson on Twitter We really hope you've enjoyed this episode of Run to the Top. The best way you can show your support of the show is to share this podcast with your family and friends and share it on your Facebook, Twitter, or any other social media channel you use. The more people who know about the podcast and download the episodes, the more I can reach out to and get top running influencers, to bring them on and share their advice, which hopefully makes the show even more enjoyable for you!