Imperial College London


Faculty of MedicineDepartment of Surgery & Cancer

Professor of Critical Care



+44 (0)20 3313 4521stephen.brett Website




Hammersmith House 570Hammersmith HospitalHammersmith Campus






BibTex format

author = {Omassoli, J and Hill, NE and Woods, DR and Delves, SK and Fallowfield, JL and Brett, SJ and Wilson, D and Corbett, RW and Allsopp, AJ and Stacey, MJ},
doi = {10.1016/j.jsams.2019.04.010},
journal = {Journal of Science and Medicine in Sport},
pages = {1004--1009},
title = {Variation in renal responses to exercise in the heat with progressive acclimatisation},
url = {},
volume = {22},
year = {2019}

RIS format (EndNote, RefMan)

AB - ObjectivesTo investigate changes in renal status from exercise in the heat with acclimatisation and to evaluate surrogates markers of Acute Kidney Injury.DesignProspective observational cohort study.Methods20 male volunteers performed 60 min standardised exercise in the heat, at baseline and on four subsequent occasions during a 23-day acclimatisation regimen. Blood was sampled before and after exercise for serum creatinine, copeptin, interleukin-6, normetanephrine and cortisol. Fractional excretion of sodium was calculated for corresponding urine samples. Ratings of Perceived Exertion were reported every 5 min during exercise. Acute Kidney Injury was defined as serum creatinine rise ≥26.5 μmol L−1 or fall in estimated glomerular filtration rate >25%. Predictive values of each candidate marker for developing Acute Kidney Injury were determined by ROC analysis.ResultsFrom baseline to Day 23, serum creatinine did not vary at rest, but showed a significant (P < 0.05) reduction post-exercise (120 [102, 139] versus 102 [91, 112] μmol L−1). Acute Kidney Injury was common (26/100 exposures) and occurred most frequently in the unacclimatised state. Log-normalised fractional excretion of sodium showed a significant interaction (exercise by acclimatization day), with post-exercise values tending to rise with acclimatisation. Ratings of Perceived Exertion predicted AKI (AUC 0.76, 95% confidence interval 0.65–0.88), performing at least as well as biochemical markers.ConclusionsHeat acclimatization is associated with reduced markers of renal stress and AKI incidence, perhaps due to improved regional perfusion. Acclimatisation and monitoring Ratings of Perceived Exertion are practical, non-invasive measures that could help to reduce renal injury from exercise in the heat.
AU - Omassoli,J
AU - Hill,NE
AU - Woods,DR
AU - Delves,SK
AU - Fallowfield,JL
AU - Brett,SJ
AU - Wilson,D
AU - Corbett,RW
AU - Allsopp,AJ
AU - Stacey,MJ
DO - 10.1016/j.jsams.2019.04.010
EP - 1009
PY - 2019///
SN - 1440-2440
SP - 1004
TI - Variation in renal responses to exercise in the heat with progressive acclimatisation
T2 - Journal of Science and Medicine in Sport
UR -
UR -
UR -
VL - 22
ER -