Scalzotto E, Corradi V, Brendolan A, Orrasch M, Fortunato A, Giavarina D and Ronco C
Introduction and Aims: Medical problems occur at high altitude. The classical physiological responses to high altitude include hyperventilation, polycythemia and hypoxiemia. Type 1 diabetes (T1D) can participate in extreme altitude mountaineering. The prevalence of acute kidney injury (AKI) at high altitude is not known. We studied the renal function, by urinary Neutrophil gelatinase-associated lipocalin (uNGAL) in high altitude, as a promising biomarker for early detection of AKI.
Methods: The 2012 ADIQ Expedition team included 4 male Caucasians participants (prt): two with T1D and two non-diabetics. Urine Glucose, Protein, Urobilinogen, pH, Specific Gravity, Blood, Ketones, Nitrite and Leucocytes were determinated on-site by Aution Sticks. The uCreatinine and uUrea were measured by F360 analyzer. uNGAL concentration was measured by the ARCHITECT urine NGAL assay. Microalbumin concentration was obtained by Beckman Image. Urine Total Protein measured by Dimension Vista analyser. The data has been normalized for urinary creatinine.
Results: All expedition prt collected the urine samples (5000, 5600 m). The urinary qualitative results by dipstick evaluation showed normal values in all cases. The values of glycaemia in T1D prt were high after arrival at basecamp (without presence of ketones). The uNGAL concentrations and uNGAL/uCrea ratios were also lower than 132 ng/ml (cut-off of uNGAL) in all participants.
Conclusions: All the prt had normal uNGAL during the time of expedition, suggesting normal renal activity also confirmed by the analysis of the other parameters. The renal function in T1D prt was preserved despite the abnormal metabolic state represented by hyperglycemia. In this type of activity, level of training is especially important.
