Burn and Trauma Associated Proteinuria: The Role of Lipid Peroxidation, Renin and Myoglobin

Abstract

Ten trauma patients and 13 burns patients were studied intensively for the first 36 h and subsequent 6 days post injury in order to investigate the mechanism of trauma and burn associated proteinuria. Burns patient's initial maximum proteinuria occurred between 4 and 8 h post injury, whilst trauma patients showed greatest proteinuria within 4 h. In both groups coexisting myoglobinuria or marked elevation of serum renin activity was not found during the first 36 h. Following admission serum lipid peroxides rose in burns patients reaching a maximum between 2 and 8 h following injury, after which levels fell rapidly; in contrast trauma patient's values were initially within normal limits, but rose sharply after 12 h with peaks occurring between 16 h and 7 days post injury. Some patients within both groups showed a recurrent protein leak 2 to 5 days post injury. The data suggest that myoglobinuria or raised renin levels do not play an important role in trauma associated proteinuria.

Relationship of Microalbuminurea in Non-Diabetic and Non-Hypertensive Patients with Acute Myocardial Infarction

“…Haffner et al [18] considered Microalbuminuria as a cardiovascular risk factor in the non-diabetic patients. Gosling et al [19,20], also considered it to be an emerging cardiovascular risk factor though he felt more studies are required to come to conclusion. Our study agrees with these observations as it shows a significant Microalbuminuria in the acute myocardial infarction patients and they are non-diabetic.…”

Immunohistochemical investigations to demonstrate vital direct traumatic damage of skeletal muscle

“…In the adjacent 'indirect damage' zone the main cause of the alterations would seem to be caused by chemical factors such as hypoxaemia induced by the primary lesion. -The influence that a variety of disturbances have on striated muscle fibres is well known: a release of myoglobin occurs even after clamping of blood vessels during operations [16] or after a rise in temperature [4]. Accompanying factors such as haemorrhage, oedema and the various stages of inflammation could therefore be contributing factors to the indirect lesions.…”

Utility of Urine Myoglobin for the Prediction of Acute Renal Failure in Patients with Suspected Rhabdomyolysis: A Systematic Review

“…The study designs included 32 case series , 16 cohort studies (11,(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59), and 4 case control studies (60 -63 ), for a total of 2399 subjects. Of the 52 studies, 16 measured uMb in only a portion of their study group.…”

“…Twenty studies looked at drugs or toxins (therapeutic/drugs of abuse, alcohol, insect venoms, snake venoms, heavy metals) (13, 14, 16, 18, 20 -23, 27, 28, 32, 33, 38, 43, 44, 52, 55, 56, 59, 63 ), 20 referred to trauma (crush injuries, motor vehicle accidents, surgery, physical torture and abuse, long-term confinement without changing position) (11, 21, 24 -26, 27, 29, 30, 34 -36, 38, 42, 44, 45, 48, 53, 54, 56, 59 ), 17 to infection (11,15,17,23,26,27,29,35,38,40,41,43,44,47,55,56,62 ), 12 to physical exertion (strainful muscle exercise, excessive muscle activity, seizures, longdistance running) (11, 23, 25-27, 30, 31, 38, 39, 43, 44, 49 ), 11 to metabolic disturbance (metabolic syndromes, endocrine disorders, electrolytes imbalances) (11,15,19,23,27,35,41,43,44,55,56 ), 9 to burns (thermal injury, high-voltage electrical injury, lightning) (19,26,35,38,46,48,50,57,58 ), 7 to asphyxiation (19,21,35,…”