myoglobinuria myoglobinuria myoglobinuria is the presence of myoglobin in the urine, which usually results from rhabdomyolysis or muscle injury. myoglobin is present in muscle cells as a reserve of oxygen. myoglobinuriaurine from a person with rhabdomyolysis showing the characteristic brown discoloration as a result of myoglobinuriaspecialtynephrology signs and symptoms signs and symptoms of myoglobinuria are usually nonspecific and needs some clinical prudence. therefore, among the possible signs and symptoms to look for would be: swollen and painful muscles fever, nausea delirium (elderly individuals) myalgia dark urine calcium ion loss causes model of helical domains in myoglobin. trauma, vascular problems, malignant hyperthermia, certain drugs and other situations can destroy or damage the muscle, releasing myoglobin to the circulation and thus to the kidneys. under ideal situations myoglobin will be filtered and excreted with the urine, but if too much myoglobin is released into the circulation or in case of kidney problems, it can occlude the kidneys' filtration system leading to acute tubular necrosis and acute kidney injury. other causes of myoglobinuria include: mcardle's disease phosphofructokinase deficiency carnitine palmitoyltransferase ii deficiency malignant hyperthermia polymyositis lactate dehydrogenase deficiency adenosine monophosphate deaminase deficiency type 1 thermal or electrical burn pathophysiology myoglobinuria pathophysiology consists of a series of metabolic actions in which damage to muscle cells affect calcium mechanisms, thereby increasing free ionized calcium in the cytoplasm of the myocytes (concurrently decreasing free ionized calcium in the bloodstream). this, in turn, affects several intracellular enzymes that are calcium-dependent, thereby compromising the cell membrane, which in turn causes the release of myoglobin.