The Role of Rapid Urine Myoglobin Test in Early Detection of Renal Involvement in Crushing Injury:
Possible Implication in Disaster Medicine

Tzong-Luen Wang, MD, PhD; Aming Chor-Ming Lin, MD, Hon-Ping Ma, MD,Hang Chang, MD, PhD

Abstract --To investigate the role of rapid urine test for myoglobin in early detection of renal involvement in crushing injury, we underwent a prospective investigation to study a urine rapid test specific for myoglobin in the specific population. Fifty-four consecutive patients presenting with crushing injury and a serum creatine kinase (CK) of >5000 IU/L from 1999 to 2001 have been enrolled as study population. Serum CK and its isoenzyme CK-MB, serum and urine myoglobin were also measured. A urine rapid myoglobin test was also performed as comparisons. All of the victims with crushing injury accepted standard medical and surgical treatment as indicated. The rate of renal involvement was about 56% (30 out of 54 patients). Urine myoglobin was present in 29 of these 30 victims (97%) with renal involvement and 2 of 24 patients (8%) without it by the rapid urine myoglobin test. The cut-off value of positive rapid urine myoglobin test was around 50 nmol/L by the ROC analysis with the sensitivity of 98% [95% CI 92-100%] and the specificity 86% [95% CI 80-92%]. In conclusion, the rapid urine myoglobin test can provide a rapid and reliable test for early detection of renal involvement in crushing injury.