“The Snow Society “, the Netflix film nominated for an Oscar for Best Foreign Language Film, brought to the screen in a hyper-realistic way the details of one of the most impactful survival stories of the last fifty years.
The hostile climate, lack of food, a series of avalanches and the emotional challenge of spending 72 days at the top of the Andes, knowing that the authorities had suspended the search, were just some of the difficulties faced by members of the Uruguayan rugby team traveling to Chile for a sports competition.
A health problem is portrayed almost as a detail by the film's director, Spanish filmmaker Juan Antonio Bayona, and caught the public's attention: the survivors were urinating in a dark brown, almost black color.
Although there is a scene showing this and a moment in which the survivors mention what happened, the film does not provide an explanation for the physiological phenomenon.
In addition to the specific episode, urine color is an important indicator of several issues related to hydration levels, quantity and quality of food, organ health and even the intake of certain medications.
Experts consulted by CNN en Español agreed that the dark urine could be related to dehydration, even though the survivors ingested water through a rudimentary system to melt the snow.
“The kidneys are a filter for the blood; they help us eliminate toxins as well as water. When they lack water, the kidneys produce a dark color, not black, but very dark. Therefore, if you don't drink liquids, you will produce little urine, thick and an intense yellowish-orange color. On the contrary, if you drink a lot of water, your urine will be clear”, explains Elmer Huerta, professor of Medicine at George Washington University and contributor to CNN.
However, the medical expert stated that the films have elements of fiction and dramatization: “Perhaps this almost black color is an exaggeration. It’s likely to be dark, yes, but not that dark.”
Juan Cardenas Rosales, an internist and medical leader at Mayo Clinic's international practice in Jacksonville, Florida, includes other factors in explaining dehydration.
“Of course, water is what causes the pale yellow color. But I don't believe dehydration would lead to such a dark color; it should be combined with something else.”
When investigating reasons other than dehydration, both experts agree on a possible diagnosis.
“I think there is a second explanation related to the cold,” says Huerta. “The intense cold generates hypothermia, a phenomenon to which all survivors were subjected. Several studies indicate that those who suffer severe hypothermia undergo a process of destruction of muscle cells. This is called rhabdomyolysis,” she detailed.
In fact, severe hypothermia causes the destruction of muscle cells, which release a substance called myoglobin into the bloodstream, according to an article published in the National Library of Medicine of the United States National Institutes of Health (NIH). When myoglobin reaches the blood, it causes a very dark brown color in the urine, according to Dr. Huerta, in the condition identified as rhabdomyolysis or “tail “.
“In the case of survivors from the Andes, the clinical picture could include dehydration, more hypothermia, more 'rhabdo',” Huerta told CNN.
For doctor Cardenas Rosales, the Dark urine could also be caused by kidney damage from rhabdomyolysis . However, he highlights another cause, besides cold, for this condition.
“Exercising too much or, as in the case of the Andean survivors, exerting yourself excessively, can also result in rhabdomyolysis. It consists of the release of a toxin from the breakdown of muscle tissue that can sometimes damage the kidneys,” he explained.
In both cases, Rhabdomyolysis is a form of damage that causes muscle fibers to die and released into the bloodstream. Without immediate medical attention, can cause long-lasting kidney complications according to a CNN article.
Although this is the most conclusive explanation regarding those involved in the Andes tragedy, Cardenas Rosales insists that, under normal conditions, this dark color in urine can be caused by multiple factors.
“It could be from foods such as beets, aloe, or antibiotics or some medications used for constipation and seizures. It may also be related to chronic conditions, such as urinary tract infections. And it could also be due to some bleeding in the urinary system”, he concludes.
Source: CNN Brasil
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