Rust urine after intense hand drumming is caused by extracorpuscular hemolysis.

Full Abstract

BACKGROUND

AND OBJECTIVES:
During Carnival, groups of > or =60 drummers go drumming with their hands and marching for periods of 2 to 4 h. The objective of this study was to determine the frequency and type of urinary abnormalities after candombe drumming and to evaluate possible pathogenic mechanisms. DESIGN, SETTING, PARTICIPANTS, &

MEASUREMENTS:
For analysis of pathogenic mechanisms, a group of individuals were prospectively evaluated before and after candombe drumming. Methods:
Candombe drummers were recruited in January 2006, 1 wk before prolonged drumming. After clinical evaluation, urine and blood samples were obtained before and immediately after drumming.

RESULTS:
Forty-five healthy individuals (four women and 41 men), median age 31 yr (14 to 56), were evaluated. Predrumming urine and plasma samples were obtained for 30 individuals. Nineteen (42%) of 45 had a previous history of rust urine emission temporally related with candombe drumming. After drumming, 18 of 26 showed urine abnormalities; six of 26 showed rust urine, eight of 26 had microhematuria, and seven of 26 had proteinuria >1 g/L. The candombe drummers who showed rust urine after heavy drumming presented significantly higher levels of lactate dehydrogenase and total bilirubin when compared with those without urine abnormalities. Haptoglobin was significantly lower in the rust urine group. Fragmented red cells were observed in the blood smear of individuals with rust urine. Rust urine after drumming was associated with previous episodes of rust urine and glucosuria.

CONCLUSIONS:
Taken together, these data confirm that rust urine is caused by extracorpuscular hemolysis.

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Author information

Author/s: Tobal, Diego (D); Olascoaga, Alicia (A); Moreira, Gabriela (G); Kurdián, Melania (M); Sanchez, Fernanda (F); Roselló, Maria (M); Alallón, Walter (W); Martinez, Francisco Gonzalez (FG); Noboa, Oscar (O);

Affiliation: Centro de Nefrología, Hospital de Clínicas, Facultad de Medicina Universidad de la República, Montevideo, Uruguay.

Journal and publication information

Publication Type: Journal Article

Journal: Clinical journal of the American Society of Nephrology : CJASN (Clin J Am Soc Nephrol), published in United States. (Language: eng)

Reference: 2008-Jul; vol 3 (issue 4) : pp 1022-7

Dates: Created 2008/06/30; Completed 2008/08/26;

PMID: 18434617, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Bilirubin - blood
Female
Glycosuria - blood; urine
Hand
Haptoglobins - metabolism
Hematuria - blood; urine
Hemoglobins - metabolism
Hemoglobinuria - blood; urine

Hemolysis
Humans
L-Lactate Dehydrogenase - blood
Male
Middle Aged
Muscle Contraction
Muscle, Skeletal - metabolism
Music
Prospective Studies
Uruguay

Associated Chemicals: Haptoglobins (0) ; Hemoglobins (0) ; Bilirubin (635-65-4) ; L-Lactate Dehydrogenase (EC 1.1.1.27)

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