Análise de Biomarcadores Urinários para Controle da Rabdomiólise em Militares de Elite Durante Curso Operacional da Secretaria de Estado de Polícia Militar do Rio de Janeiro

Abstract

The laboratory diagnosis of rhabdomyolysis is primarily based on the determination of plasma creatine kinase (CK) levels due to muscle necrosis and the release of intracellular muscle constituents into the circulation. This study aimed to evaluate renal permeability during the monitoring of the onset and development of rhabdomyolysis in military police officers during the Tactical Motor Patrol Course of the Shock Police Battalion (BPChq) and the Special Operations Course of the Special Operations Battalion (BOPE), through an analysis of the renal health of the military personnel. As methods for obtaining the results were divided into four stages. In Study 1, a systematic review of case studies of individuals who experienced episodes of rhabdomyolysis during SARS-CoV-2 infection and COVID-19 manifestation was conducted. This allowed the identification of the applicability of the urine test strip for obtaining biomarkers: pH, proteins, glucose, ketones, hemoglobin, bilirubin, urobilinogen, nitrite, density, and leukocytes. In Study 2, the urinary biomarkers from the test strip were analyzed and correlated with the coloration of the urine using the spectrophotometer method. In Study 3, the urinary biomarkers from the test strip were analyzed and correlated with the coloration using the spectrophotometer method and total proteins using the Biuret method, for the evaluation of the urinary proteome. In Study 4, the urinary biomarkers from the test strip were analyzed and correlated with the coloration of the urine using the spectrophotometer method, in absolute values, total proteins, albumin, gamma-glutamyltransferase (GGT), and creatinine using the Jaffe method, for the evaluation of renal function. The Spearman correlation test revealed an association between urine coloration and urinary biomarkers nitrite, pH, density, ketone bodies, gamma-glutamyltransferase, creatinine, and urinary proteome. The Mann-Whitney and T-Student tests indicated that intense exercise triggered recurrent hematuria and transient proteinuria, with overload on the renal system without compromising glomerular filtration. The analysis of urinary biomarkers and the methods used were effective for monitoring the renal health of military personnel and preventing the onset and development of rhabdomyolysis during operational courses. This allows the high demand levels of military operational courses to continue in the preparation of elite troops, minimizing the risk of morbidity and mortality resulting from training