{"id":"https://openalex.org/W2528060751","doi":"https://doi.org/10.1123/ijsnem.2016-0135","title":"Exertional Hyponatremia and Serum Sodium Change During Ultraendurance Cycling","display_name":"Exertional Hyponatremia and Serum Sodium Change During Ultraendurance Cycling","publication_year":2016,"publication_date":"2016-10-06","ids":{"openalex":"https://openalex.org/W2528060751","doi":"https://doi.org/10.1123/ijsnem.2016-0135","mag":"2528060751","pmid":"https://pubmed.ncbi.nlm.nih.gov/27710151"},"language":"en","primary_location":{"id":"doi:10.1123/ijsnem.2016-0135","doi":"https://doi.org/10.1123/ijsnem.2016-0135","is_oa":false,"landing_page_url":"https://doi.org/10.1123/ijsnem.2016-0135","pdf_url":null,"source":{"id":"https://openalex.org/S54215592","display_name":"International Journal of Sport Nutrition and Exercise Metabolism","issn_l":"1526-484X","issn":["1526-484X","1543-2742"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310322142","host_organization_name":"Human Kinetics","host_organization_lineage":["https://openalex.org/P4310322142"],"host_organization_lineage_names":["Human Kinetics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Sport Nutrition and Exercise Metabolism","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5026953166","display_name":"Lawrence E. Armstrong","orcid":"https://orcid.org/0000-0002-9230-6925","observed_orcids":["https://orcid.org/0000-0002-9230-6925"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Lawrence E. Armstrong","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063634399","display_name":"Elaine C. Lee","orcid":"https://orcid.org/0000-0003-4105-7620","observed_orcids":["https://orcid.org/0000-0003-4105-7620"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Elaine C. Lee","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084902135","display_name":"Douglas J. Casa","orcid":"https://orcid.org/0000-0002-8858-2636","observed_orcids":["https://orcid.org/0000-0002-8858-2636"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Douglas J. Casa","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031216859","display_name":"Evan C. Johnson","orcid":"https://orcid.org/0000-0002-5134-9718","observed_orcids":["https://orcid.org/0000-0002-5134-9718"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Evan C. Johnson","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5088688931","display_name":"Matthew S. Ganio","orcid":"https://orcid.org/0000-0001-8684-093X","observed_orcids":["https://orcid.org/0000-0001-8684-093X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Matthew S. Ganio","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061045091","display_name":"Brendon P. McDermott","orcid":"https://orcid.org/0000-0001-7238-8145","observed_orcids":["https://orcid.org/0000-0001-7238-8145"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Brendon P. McDermott","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5080675600","display_name":"Jakob Langberg Vingren","orcid":"https://orcid.org/0000-0001-8872-4502","observed_orcids":["https://orcid.org/0000-0001-8872-4502"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jakob L. Vingren","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079306681","display_name":"Hyun Min Oh","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Hyun M. Oh","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5082781577","display_name":"Keith H. Williamson","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Keith H. Williamson","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5026953166"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":1.6787,"has_fulltext":false,"cited_by_count":17,"citation_normalized_percentile":{"value":0.8228895,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":98},"biblio":{"volume":"27","issue":"2","first_page":"139","last_page":"147"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11109","display_name":"Thermoregulation and physiological responses","score":0.7856000065803528,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11109","display_name":"Thermoregulation and physiological responses","score":0.7856000065803528,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11967","display_name":"Electrolyte and hormonal disorders","score":0.1956000030040741,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11585","display_name":"Exercise and Physiological Responses","score":0.005200000014156103,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/serum-sodium","display_name":"serum sodium","score":0.8619999885559082},{"id":"https://openalex.org/keywords/fluid-intake","display_name":"fluid intake","score":0.8629999756813049},{"id":"https://openalex.org/keywords/fluid-and-electrolyte-balance","display_name":"fluid and electrolyte balance","score":0.7910000085830688},{"id":"https://openalex.org/keywords/weight-change","display_name":"weight change","score":0.7559999823570251},{"id":"https://openalex.org/keywords/sodium-intake","display_name":"sodium intake","score":0.8050000071525574},{"id":"https://openalex.org/keywords/rehydration","display_name":"rehydration","score":0.4129999876022339},{"id":"https://openalex.org/keywords/heat-stress","display_name":"heat stress","score":0.4259999990463257},{"id":"https://openalex.org/keywords/recreational-cyclists","display_name":"recreational cyclists","score":0.5929999947547913}],"concepts":[{"id":"https://openalex.org/C2776703092","wikidata":"https://www.wikidata.org/wiki/Q824292","display_name":"Hyponatremia","level":2,"score":0.7159764766693115},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6184757947921753},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5307353138923645},{"id":"https://openalex.org/C2778713406","wikidata":"https://www.wikidata.org/wiki/Q474187","display_name":"Thirst","level":2,"score":0.528462827205658},{"id":"https://openalex.org/C537181965","wikidata":"https://www.wikidata.org/wiki/Q658","display_name":"Sodium","level":2,"score":0.5026195049285889},{"id":"https://openalex.org/C2113261","wikidata":"https://www.wikidata.org/wiki/Q2914458","display_name":"Extracellular fluid","level":3,"score":0.4816628694534302},{"id":"https://openalex.org/C135760203","wikidata":"https://www.wikidata.org/wiki/Q7900636","display_name":"Urine specific gravity","level":3,"score":0.42322731018066406},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.36891356110572815},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.3645458221435547},{"id":"https://openalex.org/C185592680","wikidata":"https://www.wikidata.org/wiki/Q2329","display_name":"Chemistry","level":0,"score":0.1846613883972168},{"id":"https://openalex.org/C2780026642","wikidata":"https://www.wikidata.org/wiki/Q40924","display_name":"Urine","level":2,"score":0.12966644763946533},{"id":"https://openalex.org/C28406088","wikidata":"https://www.wikidata.org/wiki/Q5571762","display_name":"Extracellular","level":2,"score":0.08978360891342163},{"id":"https://openalex.org/C55493867","wikidata":"https://www.wikidata.org/wiki/Q7094","display_name":"Biochemistry","level":1,"score":0.0},{"id":"https://openalex.org/C178790620","wikidata":"https://www.wikidata.org/wiki/Q11351","display_name":"Organic chemistry","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001642","descriptor_name":"Bicycling","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003163","descriptor_name":"Competitive Behavior","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004326","descriptor_name":"Drinking","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005082","descriptor_name":"Physical Exertion","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006358","descriptor_name":"Hot Temperature","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007010","descriptor_name":"Hyponatremia","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D007010","descriptor_name":"Hyponatremia","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D007010","descriptor_name":"Hyponatremia","qualifier_ui":"Q000517","qualifier_name":"prevention & control","is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009120","descriptor_name":"Muscle Cramp","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D009120","descriptor_name":"Muscle Cramp","qualifier_ui":"Q000517","qualifier_name":"prevention & control","is_major_topic":false},{"descriptor_ui":"D010807","descriptor_name":"Physical Endurance","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012964","descriptor_name":"Sodium","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D012982","descriptor_name":"Sodium, Dietary","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D013781","descriptor_name":"Texas","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013894","descriptor_name":"Thirst","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014887","descriptor_name":"Weather","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015331","descriptor_name":"Cohort Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015444","descriptor_name":"Exercise","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D054874","descriptor_name":"Athletic Performance","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D056352","descriptor_name":"Athletes","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D064133","descriptor_name":"Sports Nutritional Physiological Phenomena","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1123/ijsnem.2016-0135","doi":"https://doi.org/10.1123/ijsnem.2016-0135","is_oa":false,"landing_page_url":"https://doi.org/10.1123/ijsnem.2016-0135","pdf_url":null,"source":{"id":"https://openalex.org/S54215592","display_name":"International Journal of Sport Nutrition and Exercise Metabolism","issn_l":"1526-484X","issn":["1526-484X","1543-2742"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310322142","host_organization_name":"Human Kinetics","host_organization_lineage":["https://openalex.org/P4310322142"],"host_organization_lineage_names":["Human Kinetics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Sport Nutrition and Exercise Metabolism","raw_type":"journal-article"},{"id":"pmid:27710151","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/27710151","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International journal of sport nutrition and exercise metabolism","raw_type":"Case Reports"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9537000060081482}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2041112550","https://openalex.org/W2021508248","https://openalex.org/W7030560209","https://openalex.org/W4234559053","https://openalex.org/W2058538229","https://openalex.org/W23315855","https://openalex.org/W2313002491","https://openalex.org/W2044524236","https://openalex.org/W2030130491","https://openalex.org/W172028366"],"abstract_inverted_index":{"Introduction:":[0],"Exertional":[1],"hyponatremia":[2],"(EH)":[3],"during":[4,184],"prolonged":[5],"exercise":[6,73,127,188],"involves":[7],"all":[8],"avenues":[9],"of":[10,20,32,60,90,98,112,132,157,168,181,187,247,261,282],"fluid-electrolyte":[11],"gain":[12],"and":[13,40,67,102,129,137,145,154,160,189,220,231,286],"loss.":[14],"Although":[15],"previous":[16],"research":[17],"implicates":[18],"retention":[19],"excess":[21],"fluid,":[22],"EH":[23,248],"may":[24],"involve":[25],"either":[26],"loss,":[27],"gain,":[28],"or":[29],"no":[30],"change":[31,234],"body":[33,182,192,232],"mass.":[34],"Thus,":[35],"the":[36,96,198,245,280],"etiology,":[37],"predisposing":[38],"factors,":[39],"recommendations":[41],"for":[42,46,142],"prevention":[43],"are":[44],"vague\u2014except":[45],"advice":[47],"to":[48,107,266,271,277],"avoid":[49],"excessive":[50],"drinking.":[51],"Purpose:":[52],"This":[53],"retrospective":[54],"field":[55],"study":[56],"presents":[57],"case":[58],"reports":[59],"two":[61,148],"unacquainted":[62],"recreational":[63],"cyclists":[64,115,150],"(LC,":[65],"31y":[66],"AM,":[68],"39":[69],"years)":[70],"who":[71],"began":[72],"with":[74,86,210,223],"normal":[75],"serum":[76,88,169,205,262],"electrolytes":[77],"but":[78],"finished":[79],"a":[80,87,108,152],"summer":[81],"164-km":[82],"ride":[83],"(ambient,":[84],"34\u0081\u00b15\u00b0C)":[85],"[Na+]":[89,206,263],"130":[91],"mmol/L.":[92],"Methods:":[93],"To":[94],"clarify":[95],"etiology":[97],"EH,":[99],"their":[100],"pre-":[101],"post-exercise":[103,130],"measurements":[104],"were":[105,140,284],"compared":[106],"control":[109],"group":[110],"(CON)":[111],"31":[113],"normonatremic":[114],"(mean":[116],"\u0081\u00b1":[117],"SD;":[118],"37\u0081\u00b16":[119],"years;":[120],"141\u0081\u00b13":[121],"mmol":[122,251],"Na+/L).":[123],"Results:":[124],"Anthropomorphic":[125],"characteristics,":[126],"time,":[128],"ratings":[131],"thermal":[133],"sensation,":[134],"perceived":[135],"exertion":[136],"muscle":[138],"cramp":[139],"similar":[141,155],"LC,":[143],"AM":[144,190],"CON.":[146],"These":[147],"hyponatremic":[149],"consumed":[151],"large":[153],"volume":[156],"fluid":[158,212],"(191":[159],"189":[161],"ml/kg),":[162],"experienced":[163],"an":[164,273],"11":[165],"mmol/L":[166],"decrease":[167],"[Na+],":[170],"reported":[171],"low":[172],"thirst":[173],"sensations;":[174],"however,":[175],"LC":[176],"gained":[177],"3.1":[178],"kg":[179],"(+4.3%":[180],"mass)":[183],"8.9":[185],"hr":[186],"maintained":[191],"mass":[193,233],"(+0.1kg,":[194],"+0.1%,":[195],"10.6h).":[196],"In":[197],"entire":[199],"cohort":[200],"(n":[201],"=":[202,215,229,236,239],"33),":[203],"post-event":[204],"was":[207],"strongly":[208],"correlated":[209,221],"total":[211],"intake":[213,226],"(R2":[214,235],"0.45,":[216],"p":[217,228,238],"<":[218],".0001),":[219],"moderately":[222],"dietary":[224],"sodium":[225],"(R2=0.28,":[227],".004)":[230],"0.22,":[237],".02).":[240],"Linear":[241],"regression":[242],"analyses":[243],"predicted":[244],"threshold":[246],"onset":[249],"(<135":[250],"Na+/L)":[252],"as":[253],"168":[254],"ml":[255],"fluid/kg.":[256],"Conclusions:":[257],"The":[258],"wide":[259],"range":[260],"changes":[264],"(+6":[265],"-11":[267],"mmol/L)":[268],"led":[269],"us":[270],"recommend":[272],"individualized":[274],"rehydration":[275],"plan":[276],"athletes":[278],"because":[279],"interactions":[281],"factors":[283],"complex":[285],"idiosyncratic.":[287]},"counts_by_year":[{"year":2025,"cited_by_count":5},{"year":2024,"cited_by_count":1},{"year":2021,"cited_by_count":3},{"year":2020,"cited_by_count":1},{"year":2019,"cited_by_count":2},{"year":2018,"cited_by_count":2},{"year":2017,"cited_by_count":3}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-10-14T00:00:00"}