Burns research & reconstructive surgery

Toxic effect of myoglobin on kidney function in burns patients

Perry S., Li Z., Maitz P., Millis D. and Witting P.

Myoglobin is a haem-containing protein that is present in relatively high concentration in cardiac and skeletal muscle. Recently, the presence of myoglobin has been confirmed in human smooth muscle. The role of intracellular myoglobin is generally accepted as that of a passive di-oxygen storage protein. However, myoglobin can promote damage to lipids and proteins from cells that may lead to dysfunction.

Acute renal failure (ARF) is a well-known complication of severe burns and is an important factor leading to an increase in mortality. In patients with significant burns (>25% total skin surface), the incidence of myoglobinuria (excessive concentration of circulating myoglobin) and hypotension during the resuscitation phase was significantly higher in the group with early acute renal failure. Extracellular myoglobin is rapidly cleared from the circulation through the kidney suggesting that the accumulation of myoglobin in the kidney may be responsible, at least in part, for the enhanced ARF. Currently, it is unknown if myoglobin promotes damage to the kidney in burns patients and whether, and if so how, myoglobin contributes to the development of ARF in burns patients.

This study has been designed to investigate the potential effects of extracellular myoglobin on renal function following severe burns.