Marathon running and cell-cycle arrest biomarkers of acute kidney injury

Todd Leckie, Daniel Fitzpatrick, Alan J Richardson, Alex Hunter, Sonia Bains, Rachael Grimaldi, Rob Galloway, Lui G Forni, Luke E Hodgson

Research output: Contribution to journalArticlepeer-review


Endurance exercise is known to cause a rise in serum creatinine. It is not known to what extent this rise reflects renal stress and a potential acute kidney injury (AKI). Increases in Insulin Like Growth Factor Binding Protein 7 (IGFBP7) and Tissue Inhibitor of Metalloprotinases-2 (TIMP-2), urinary biomarkers of cell cycle arrest and renal stress, are associated with the development of AKI.

Repeated measures study

Runners were recruited at the 2019 Brighton Marathon (UK) and provided urine and blood samples at baseline, immediately post-race and 24hrs post-race. Serum creatinine, urinary creatinine and urinary IGFBP7 and TIMP-2 were analysed from the samples.

Seventy nine participants (23 females, 56 males), aged 43 ± 10yrs (mean ± SD), finish time 243 ± 40mins were included for analysis. Serum creatinine increased over the race by 40 ± 26% (p<0.001), TIMP-2 increased by 555 ± 697% (p<0.001) and IGFBP7 increased by 1094 ± 1491% (p<0.001) over the race. A subset of twenty-two participants supplied samples 24 hours post-race, reporting values similar to baseline at for all variables by this time. Significant increases (p<0.01) were seen in markers when corrected for urinary creatinine.

This study is the first to report large rises in IGFBP7 and TIMP-2 following marathon running. This suggests that rises in creatinine are not fully explained by changes in production and clearance and may reflect a state of kidney stress, or injury.

Original languageEnglish
Pages (from-to)14-18
Number of pages5
JournalJournal of Science and Medicine in Sport
Issue number1
Publication statusPublished - 24 Oct 2022

Bibliographical note

Funding Information:
This study was funded by the British Association of Sport and Exercise Medicine 2019 research bursary. The bursary paid for the equipment and consumables required to collect the blood and urine samples. The processing and measurement of the biomarkers was performed free of charge by Ortho Clinical Diagnostics (Felindre Meadows, Pencoed, Bridgend CF35 5PZ). Samples were provided to Ortho Clinical Diagnostics following sample anonymisation and Ortho Clinical Diagnostics had no role in study design, data collection or manuscript writing.

Funding Information:
Thanks go to the Brighton marathon organisers, medical team and of course the willing runners. The project was funded by the British Association of Sport and Exercise Medicine (BASEM). We are grateful for the support of Ortho Clinical Diagnostics (OCD), Felindre Meadows, Pencoed, Bridgend CF35 5PZ for the measurements of TIMP-2 and IGFBP-7 without which this study would not have been possible. Neither BASEM nor OCD were involved in study design, data analysis or manuscript production.

Publisher Copyright:
© 2022 Elsevier Ltd


  • Biomarker
  • Endurance
  • IGFBP7
  • Running
  • TIMP-2
  • Acute kidney injury


Dive into the research topics of 'Marathon running and cell-cycle arrest biomarkers of acute kidney injury'. Together they form a unique fingerprint.

Cite this