Premium
Recurrent exercise‐induced acute renal failure in renal hypouricemia
Author(s) -
Ninomiya M,
Ito Y,
Nishi A,
Matsumoto T,
Kogal A,
Hori Y,
Nishida H,
Nomura G,
Kato H
Publication year - 1996
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1996.tb14206.x
Subject(s) - medicine , uric acid , acute tubular necrosis , benzbromarone , reabsorption , renal physiology , renal biopsy , creatinine , endocrinology , renal function , hypouricemia , urology , kidney , hyperuricemia
We describe a male patient with four episodes of acute renal failure after strenuous exercise occurring between the age of 14 and 25 years. He was found to have low serum uric acid (0.4mgdl −1 after recovery) and high fractional excretion of uric acid. A benzbromarone, pyrazinamide test suggested that renal hypouricemia was due to defective proximal tubular reabsorption of uric acid at a pre‐secretory site. A renal biopsy revealed acute tubular necrosis, a renal computer tomography scan showed patchy contrast enhancement and a treadmill exercise test induced an immediate fall in creatinine clearance. These findings suggest that the cause of acute renal failure was renal vasoconstriction rather than obstruction by uric acid crystals.