PIGMENT NEPHROPATHY IN DRUMMERS: “IF YOU DON'T URINATE DARK AFTER PLAYING THE DRUMS, DID YOU REALLY PLAY THE DRUMS?"

Pigmenturia is common among individuals who regularly play the drums, it is even recognized as a sign of talent and success in the drummers community. We report a serie of three argentine percussionists who presented dark-colored urine and acute kidney injury after an intense and prolonged hand-drumming session. We also describe its epidemiological characteristics.

We retrospectively analyzed the main clinical data of the three patients admitted at Hospital Fernández between 2021 and 2023 who presented pigmenturia and acute kidney failure after vigorous and prolonged hand-drumming. At the same time, a virtual and anonymous survey was distributed among members of the Argentinian Society of Drummers in August 2023 in order to know the impact and prevalence of this entity in our country.

Three male percussionists with an average age of 27 years were studied. None of them reported any previous pathological history. They suffered from abdominal and low back pain, nausea and vomiting associated with the passing of dark colored urine that began shortly after playing the drums with their hands vigorously with little fluid intake. At the time of admission, they had kidney injury (eGFR CKD-EPI average 8.8 ml/min/m2), haemoglobinuria, eumorphic microhematuria, leukocyturia, elevated lactate dehydrogenase and normal seric creatine-phosphokinase. A renal biopsy was performed in two patients and showed pigmented granular intratubular casts, intracytoplasmic hemosiderin pigments and signs of acute tubular necrosis. Initially, all required ev. fluids due to volume depletion. Two patients were refractory, requiring hemodialysis. In the following days, all showed progressive kidney improvement, achieving complete recovery of the renal function in an average of two weeks (Table N°. 1).

Conclusions