High-Altitude Medical

HANDBOOK

DEHYDRATION

During acclimatization, the body naturally produces a larger amount of urine. This is a normal sign of adaptation to altitude, but it also means more frequent urination during the day and at night.

Physical exertion during warm days in the mountains, as well as breathing cold and very dry air, increases fluid loss. In addition, traveler’s diarrhea may further worsen dehydration.

The most common symptoms of dehydration include:

➤ thirst

➤ headache

➤ fatigue

➤ weakness

Dehydration can be prevented by regularly drinking several liters (about 4–5 liters) of safe fluids per day.

A good indicator of adequate hydration is urinating at least four times per day and producing larger amounts of light-colored urine, which usually indicates proper hydration.

If you are planning a high-altitude expedition and would like to prepare medically, you are welcome to take advantage of a pre-expedition medical consultation.

URINARY BLADDER INFECTION

Frequent and painful urination of small amounts of urine may be a symptom of dehydration.

If symptoms do not improve after drinking about 2 liters of fluids, a urinary tract infection (UTI) may be present and antibiotic treatment may be required.

BENIGN PROSTATIC ENLARGEMENT

In older men, natural enlargement of the prostate gland may occur. This can lead to:

➤ more frequent urination

➤ sudden urgency to urinate

➤ difficulty starting urination

In some cases, painful urinary retention may develop.

If these symptoms occur, or if there are any concerns regarding urinary system function, it is advisable to consult a urologist well before departure.

KIDNEY FAILURE

Advanced kidney failure may make it difficult to maintain proper:

➤ fluid balance

➤ acid–base balance

➤ electrolyte levels

➤ blood pressure

at high altitude.

Kidney failure may also lead to anemia, because it disrupts the production of erythropoietin, the hormone responsible for stimulating red blood cell production in the bone marrow. At high altitude, this limits the body’s ability to increase red blood cell production, which reduces acclimatization capacity and increases the risk of hypoxia and altitude illnesses such as:

➤ Acute Mountain Sickness (AMS)

➤ High-Altitude Pulmonary Edema (HAPE)

➤ High-Altitude Cerebral Edema (HACE)

A mild metabolic acidosis that may occur in people with kidney failure could theoretically reduce the risk of Acute Mountain Sickness by increasing ventilation. However, acidosis also promotes pulmonary vasoconstriction, which may increase the risk of High-Altitude Pulmonary Edema (HAPE).

Disturbances in fluid balance may further worsen hypoxia and increase the risk of altitude-related complications. Long-term exposure to high altitude may also accelerate the progression of chronic kidney disease.

People taking diuretic medications should regularly monitor their body weight at altitude and adjust medication doses accordingly.

Patients with kidney failure should avoid non-steroidal anti-inflammatory drugs (NSAIDs), as these medications may worsen kidney oxygenation by reducing the ability of renal blood vessels to dilate.

At altitude, angiotensin-converting enzyme (ACE) inhibitors may sometimes be used to reduce the risk of high-altitude proteinuria.

It is also important to remember that some medications may require dose adjustments in people with chronic kidney disease, therefore a medical consultation before the expedition is recommended.

REFERENCES

• Travel at High Altitude –www.medex.org.uk

• K. Mieske et al., Journeys to High Altitude—Risks and Recommendations for Travelers with Preexisting Medical Conditions, Journal of Travel Medicine, 2010; Volume 17 (Issue 1): 48–62

-------

WANT TO LEARN MORE?

If you want to better prepare your health for trekking or a high-altitude expeditions, check out the expanded guide in the ebook "High-Altitude Medicine for Trekkers and Climbers" >>

-----

Gain practical skills for handling emergencies in the mountains through our online training "High-Altitude First Aid" >> - prepared for those planning trips to high altitudes.

-----

 For a detailed list of what to include in your expedition medical kit and step-by-step instructions for assembling your personal first aid set, see the ebook "High-Altitude Expedition Medical Kit Guide" >>

PLANNING A TREK OR A HIGH-ALTITUDE EXPEDITION?

If you would like to check whether your health condition allows you to safely participate in a trek or high-altitude expedition, consider booking a medical consultation >> or using a telemedical expedition package >>

This allows you to assess potential health risks in advance, prepare properly fot altitude, and increase your safety during the expedition.

The company was established in 2004. The goal of MedEverest is education in the field of mountain medicine and the dangers of high altitudes. I deal with all medical aspects of staying at high altitude. I organize medical support for trekking and high-altitude expeditions.

Specialist Medical Practice Medeverest Robert Szymczak based in Gdańsk (80-360), at ul. Bolesława Krzywoustego 19F, NIP: 5841943576, REGON: 220148318.

All rights reserved. Copying content and photos is prohibited. Information obligation before consenting to data processing.(see).

Also checkStore regulations >> Implementation: ColinMedia.eu >>