Prolonged dense nephrograms in battered children. Suspect rhabdomyolysis and myoglobinuria.

Prolonged, dense nephrograms were seen on intravenous urography in 5 cases of child abuse presenting with possible renal injury. Each child had oliguria, elevated muscle enzymes, and pigmented urine positive for blood, but without red cells on microscopic examination. These findings are suggestive of myoglobinuria. The abnormalities resolved with appropriate fluid and electrolyte management. This complication of child abuse, not previously emphasized, may be suggested by the urographic findings. Possible factors contributing to the dense nephrograms are presented.