High-altitude medicine

ZONE OF KNOWLEDGE

DEHYDRATION OF THE BODY

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

Physical exertion on warm days in the mountains, as well as breathing cold and very dry air, contribute to fluid loss. Additionally, traveler's diarrhea can further exacerbate dehydration.

The most common symptoms of dehydration include:

➤ feeling thirsty

➤ headache

➤ fatigue

➤ weakness

Dehydration can be prevented by regularly consuming several liters (4-5) of safe fluids daily.

A good indicator of hydration is urinating at least four times a day with larger amounts of clear urine, which usually indicates proper hydration of the body.

If you are planning a high-altitude expedition and want to prepare medically, I invite you to take advantage of a consultation before the high-altitude trip.

BLADDER INFECTION

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

If symptoms do not resolve after drinking about 2 liters of fluids, a urinary tract infection may be present, which may require antibiotic treatment.

PROSTATE ENLARGEMENT

In older men, there is a natural enlargement of the prostate gland. This can cause:

➤ more frequent need to urinate

➤ sudden urge to urinate

➤ difficulty starting urination

In some cases, painful urinary retention may occur.

If such symptoms occur or there are doubts about the functioning of the urinary system, it is advisable to consult a urologist well in advance of the trip.

KIDNEY FAILURE

Advanced kidney failure can hinder the maintenance of proper:

➤ water balance

➤ acid-base balance

➤ electrolyte levels

➤ blood pressure

at high altitudes.

Kidney failure can also lead to anemia as it disrupts the production of erythropoietin– a hormone that stimulates the production of red blood cells in the bone marrow. In high-altitude conditions, this limits the body's ability to increase red blood cell count, reducing acclimatization capacity and increasing the risk of hypoxia and altitude sickness, such as:

➤ acute mountain sickness (AMS)

➤ high altitude pulmonary edema (HAPE)

➤ high altitude cerebral edema (HACE)

Mild metabolic acidosis occurring in people with kidney failure may theoretically reduce the risk of acute mountain sickness by increasing ventilation. However, acidosis also promotes constriction of pulmonary vessels, which may increase the risk of high altitude pulmonary edema (HAPE).

Additionally, disturbances in water balance may exacerbate hypoxia and contribute to the development of altitude-related complications.Prolonged stays at high altitudes may also accelerate the progression of chronic kidney failure.

Individuals taking diuretics should regularly monitor their weight at altitude and adjust medication doses accordingly.

Patients with kidney failure should avoid using non-steroidal anti-inflammatory drugs (NSAIDs), as they may worsen renal blood flow by restricting the dilation of renal vessels.

At altitude, ACE inhibitors are sometimes used to reduce the risk of altitude proteinuria.

It is worth remembering that some medications may require dosage modifications in individuals with chronic kidney failure, so a medical consultation is advisable before the trip.

BIBLIOGRAPHY

• 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

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WANT TO LEARNMORE?

If you want to better prepare health-wise for trekking or a high-altitude expedition, you can find the extended version of the guide in the ebook“High Altitude Medicine in Practice – A Guide for Trekking and Expeditions” >>

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You will also learn practical knowledge about emergency procedures in the mountains in the online training“High Altitude First Aid” >> - designed for those planning trips to high altitudes.

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Meanwhile, you can find the detailed contents of the expedition first aid kit and precise instructions for preparing an expedition first aid kit and personal rescue kit in the ebook“Expedition First Aid Kit – Complete Medical Guide” >>

ARE YOU PLANNING A TREKMOUNTAINHIGH-ALTITUDE EXPEDITION?

If you want to check whether your health allows you to safely participate in trekking or a high-altitude expedition, it is worth taking advantage of medical consultation >> or telemedicine expedition package >>

This way, you can assess health risks in advance, prepare properly for the trip, and increase safety while at high altitude.

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.

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