A man was tied up and spanked over 1000 times.
This is what happened to his kidneys.
BD is a 61-year-old man that presents to the hospital with blood in his urine and deep abrasions across his thighs and buttocks.
Although he seemed calm and collected, doctors suspected that BD had suffered an acute kidney injury.
BD had regularly practiced BDSM for the past 7 years.
For those unfamiliar, BDSM stands for bondage and discipline, dominance and submission, and sadism and masochism
An erotic practice that can, sometimes, incorporate violent play.
For BD, though, violent play was always on the table.
And so was he
3 days before being admitted to the hospital, BD had been tied up, naked, onto a wooden spanking table; his buttocks and thighs facing upwards and outwards.
BD noticed that his restraints had been particularly tight against his back and legs that day; he’d been fastened and restrained with several, taut ropes.
But BD thought nothing of it. The session would go on.
Having securely mounted the wooden table, his partner--equipped with several canes and whips--delivered the first, vigorous lash onto BD’s buttocks.
The sound of each lash cracked through the room--the echoes of broken skin and dribbling blood pummelling the walls.
2 lashes, 3 lashes, 4 lashes
BD had waited a month for this session. He was sure to make each of his 30 minutes count.
Each new stroke cut his skin and bruised his flesh
no matter how vigorously he’d flailed and tugged against his restraints, his ropes held tightly to BD
and squeezed his abdomen against the rigid, wooden frame of the spanking table.
After 30 minutes had passed, BD’s thighs and buttocks had become mottled with the countless bruises, slashes, and patches of crimson skin
that over 1000 strikes of cane and whip had inscribed onto his body.
BD’s ribs ached against the gristly, wooden grain of the table and his skin had formed valleys and crevasses against the tracts of the taut restraints.
And BD… well, BD thought everything had gone smoothly.
Tired, satisfied, and a little sore from the past evening,
BD drove back to his home, ate dinner, and went straight to bed
looking forward to reliving those 30 minutes come the next month.
Now, the next morning, BD was peeing blood. TOO LONG
Hematuria-- “hema-” meaning blood and “-uria” meaning urine
is defined as the presence of blood or blood cells in the urine and can be an indicator of underlying pathology or injury
Still, BD wasn’t too worried.
This hadn’t been the first time that he’d peed blood after one of his BDSM sessions.
In BD’s own words:
Fair enough.
Still, even the steeled BD had started to worry when, the next day, he found that it was impossible for him to urinate
BD had become anuric
“a-” meaning “without” and “uria- “meaning “urine”
and was about 2 kg heavier than he had been the night before.
It was then that BD realized that he might be in need of some more serious medical attention.
Yet another day later, BD finally decided to consult a general practitioner about his recent troubles.
Unsurprisingly, the GP promptly ordered a comprehensive set of laboratory investigations on BD’s behalf.
The result?
The concentration of creatinine in his blood had increased to almost 8 times the normal level.
Creatinine is a major waste product of muscular metabolism and continues to be filtered from our bodies by our kidneys.
Our kidneys are a set of powerful chemical factories that work to filter the blood from our bodies.
They remove waste products from our system, help maintain a healthy balance of water, salts, and minerals,
and plays a significant role in regulating our blood pressure.
When considering the function of a kidney, we can look at it in terms of its foundational unit: the nephron.
Here, you can see 6 of the primary structures that help the nephron function.
The first is known as the glomerulus:
this structure is responsible for filtering small solutes from the blood into what is known as the filtrate
Next, the filtrate moves to the proximal convoluted tubule.
Here, the ions are reabsorbed as along with water and other nutrients, toxins are removed, and the filtrate’s pH is adjusted.
Then we move to the descending loop of Henle,
where structures known as aquaporins allow water to move from our filtrate into the interstitial fluid.
From here, the filtrate moves to the ascending loop of Henle:
here Na+ and Cl- ions are reabsorbed from the filtrate and into the interstitial fluid and the filtrate is diluted.
As the filtrate makes its way to the distal tubule. This is where different ions are secreted (H+, K+, NH3)
and absorbed in order to maintain the blood pH and electrolyte balance
Lastly, we have the collecting duct:
here, solutes and water are reabsorbed from the filtrate.
H+ and K+ ions are secreted to maintain the electrolyte balance of the blood and maximum reabsorption of water occurs to produce concentrated urine.
Through this process, the kidneys can reintroduce nutrients to the body and filter out any toxins or waste products from our blood;
waste products like creatinine.
When our kidneys are healthy, our serum creatinine levels, meaning
the concentration of creatinine in our blood, remain relatively low;
our natural filters are working the way they should be.
That is to say, of course, the opposite also holds true:
elevated serum creatinine levels are likely indicators of depressed renal function; of kidney damage.
For BD, serum creatinine concentrations of more than 9 mg/dL, aberrant biomarkers, an abdominal ultrasound, and subsequent biopsies reveals what seemed to be a severe kidney injury.
3 days following his thousand-fold lashing, BD is admitted to the hospital with acute renal failure.
So, what happened?
In the case of BD, the likely culprits for this acute kidney injury were intermittent abdominal compartment syndrome and blunt kidney trauma.
Compartment syndrome is the final result of a process that begins with a persistent increase in pressure within a tissue
pressure great enough to stifle the vascular influx of the surrounding region and, subsequently, cause local organ failure.
Pressure that BD had felt having been restrained against a rigid, wooden table by several, taut ropes.
With each minute that BD spent on the spanking table, the greater his intrarenal pressure became
causing the kidney to swell, reducing vascular inflow, and inducing ischemia of the outer medulla.
Having spent over 30 minutes in this squashed, prone position, BD experienced a significant reduction in renal perfusion
a circumstance that stunted his glomerular filtration, destroyed renal tissue, and lead to the development of acute renal failure.
Of course, the restraints had only represented one half of BD’s activities that night.
The whipping had also been accomplice to this assault on the renal system.
Of the 1000 lashings that BD received that night, more than a few strikes of the whip and cane had strayed off the projected course.
Most would land on the padded surfaces of his buttocks and thighs, sure.
But every once in a while, these vigorous swings would strike the flesh of his back.
And BD thought nothing of it, of course. These things happened. He felt it happen before.
Yet, each time his flesh recoiled against the whistle of the whip, so too would the organs underneath.
His renal beds had been struck. Over and over, for the course of 30 minutes,
the whips and canes would batter against his body and underlying structures, slowly bruising and destroying swathes of renal tissue.
Blood seeped from the damaged nephrons and entered the urine, causing BD’s hematuria.
With each lashing against the kidneys, BD’s renal function became further impaired.
Thus, as the hypoxic environment induced by the pressure of BD’s restraints compounded with the strikes against his kidney,
BD’s kidneys continued to sustain catastrophic damage.
Abdominal compartment syndrome and blunt trauma had led to acute kidney injury and subsequent renal failure.
There’s absolutely nothing wrong with participating in BDSM.
Like anything else, with a reasonable amount of moderation, it can be a good time.
Still, there are always reasons to be careful. Fortunately, BD survived the ordeal, but others might not be as lucky.
Take some wisdom from BD himself when he says:
So, there we have it, folks. That's all for the case today. Have fun. Stay safe. Practice BDSM safely.
And as always, we’ll see you next time.