HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: CJN.04491007v1 3/4/1022    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tobal, D. Articles by Noboa, O. Search for Related Content PubMed PubMed Citation Articles by Tobal, D. Articles by Noboa, O.

Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular Hemolysis

Diego Tobal^*, Alicia Olascoaga, Gabriela Moreira, Melania Kurdián^*, Fernanda Sanchez, Maria Roselló^*, Walter Alallón, Francisco Gonzalez Martinez^*, and Oscar Noboa^*,

^* Centro de Nefrología, Laboratorio Clínico, Departamento de Fisiopatología, Hospital de Clínicas, Facultad de Medicina Universidad de la República, Montevideo, Uruguay

Correspondence: Dr. Oscar Noboa, Depto de Fisiopatología Hospital de Clinicas, Avda Italia s/n 11609, Montevideo, Uruguay. Phone/Fax: 5982-4809850; E-mail: onoboa{at}hc.edu.uy

Background and objectives: During Carnival, groups of 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.

This article has been cited by other articles:

				P. Di Nicolo, A. Zuccala, L. Gammaro, and L. Oldrizzi Severe acute renal failure in two hand-drummers after the same rhythmic session NDT Plus, August 1, 2009; 2(4): 318 - 319. [Full Text] [PDF]

				A. A. Soler-Garcia, D. Johnson, Y. Hathout, and P. E. Ray Iron-Related Proteins: Candidate Urine Biomarkers in Childhood HIV-Associated Renal Diseases Clin. J. Am. Soc. Nephrol., April 1, 2009; 4(4): 763 - 771. [Abstract] [Full Text] [PDF]