The flagged samples with high HGB concentrations are Samples 2, 15, 16 and 22. 

For Sample 2, the urine specific gravity (USG) is 1.015, for Sample 15 the USG is 1.021, for Sample 16 the USG is 1.023 and for Sample 22 the USG is 1.010. However, the urine Sample 22 was collected several hours after collection of blood sample; although it was not possible to reconstruct the scenario with certainty, it is not unlikely that Rhonex had to drink a significant volume of fluid in order to be able to produce a urine sample causing a time gap of several hours between the collection of both samples. Everything stated above confirms that when these Rhonex’s flagged samples were collected he was significantly dehydrated.

The USG values can be summarized as follows:

i) 2019 - not a single USG value of exactly or over 1.021

ii) 2020 - 5 samples of 1.021+ and 2 under 1.021

iii) 2021 - all samples under 1.021+

iv) 2022 - all out of competition samples under 1.021+

Rhonex’s hydration status can be further interpreted while applying reference to Coffman KE, Mitchell KM, Salgado RM, Miller GD, Kenefick RW, Cheuvront SN. Potential for dehydration to impact the athlete biological passport. Drug Test Anal. 2020; 12: 1206-11.