Pigmenturia e injuria renal aguda luego de percusión intensa de tambor

Diego Tobal; Alicia Olascoaga; Alicia Sans; Cristina Fernández; Patricia Larre Borges; Gabriela Moreira; Francisco González; Oscar Noboa

Authors

Diego Tobal Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología, Ex Asistente
Alicia Olascoaga Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Laboratorio Clínico, Prof. Agda.
Alicia Sans Hospital Maciel, Servicio de Nefrología de Agudos, Nefróloga
Cristina Fernández Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología, Ex Asistente
Patricia Larre Borges Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología, Ex Asistente
Gabriela Moreira Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Laboratorio Clínico, Asistente
Francisco González Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología, Prof. Director
Oscar Noboa Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología, Ex Prof. Adj. Prof. Agdo. Fisiopatología

Keywords:

ACUTE RENAL INSUFFICIENCY, PERCUSSION, HEMOLYSIS

Abstract

Background: among regular drummers it is usual the emission of rust-colored urine after sessions. Since 1999, many patients have presented rust-colored urine and acute renal injury (ARI) after sessions.
A prospective study of a group of drummers after playing intensively their instruments in order to analyze the incidence of urinary alterations and to assess pathogenic mechanisms.
Methods: people of two Candombe bands were recruited a week before the Llamadas. After obtaining the informed consent, blood and urine samples were got from the participants before the session.
Results: we assessed 26 people (3 women and 23 men). Mean age was 32 years (17-54 years). Pre-execution urine test was normal in all participants. Post-execution 18/26 (0.70) showed urinary anomalies; 6/26 (0.23) showed rust-colored urine; 8/26 (0.35) microhematuria, and 7/26 (030) proteinuria greater than 1 g/l. Mioglobine was negative in all cases.
People that showed rust-colored urine after an intense session, also presented high levels of lactate dehydrogenase hormone and total bilirrubine compared with people free of urinary anomalies. No significant differences of creatine phosphokinase plasmatic were seen.
Conclusions: data suggest that rust-colored urine emission is mainly due to extracorpuscular hemolysis induced by manual traumatisme and not caused by rabdomiolisis. Percussion players may develop ARI due to hemolysis.

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