Acute renal failure after exercise in a patient with renal hypouricemia

Hasegawa, Midori; Kawashima, Shirou; Toba, Takako; Shikano, Masahiko; Hasegawa, Hiroshi; Tomita, Makoto; Koide, Shigehisa; Asano, Shinsuke; Murakami, Kazutaka; Kato, Ryuzo

doi:10.1007/s101570050010

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Ishikawa et al (10) reported that renal CT revealed a delayed wedge-shaped patchy contrast enhancement during exercise-induced ARF in patients with idiopathic renal hypouricemia. Hasegawa et al (15) reported that renal CT showed the delayed wedgeshaped patchy contrast enhancement after exercise in a patient with idiopathic renal hypouricemia, even though the level of exercise did not induce ARF. At present, the dehydration, excessive production of oxygen free radicals, and regional vasoconstriction are considered to participate in the mechanism of exercise-induced ARF in renal hypouricemia.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to these uricosuric drugs, losartan also inhibits URAT1 (8) and urate transport in the brush-border membrane of the human kidney (23). Benzbromarone and probenecid can increase FEUA in patients classified as having a presecretory reabsorption defect of uric acid (7), who constitute the majority of cases of exercise-induced ARF (12)(13)(14)(15)(16)(17)(18)(19). Therefore, it is possible that losartan may increase FEUA even in patients with idiopathic renal hypouricemia.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Exercise-Induced Acute Renal Failure in a Patient with Idiopathic Renal Hypouricemia Developed during Antihypertensive Therapy with Losartan and Trichlormethiazide.

et al. 2003

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Case of Exercise-Induced Acute Renal Failure in a Patient with Idiopathic Renal Hypouricemia Developed during Antihypertensive Therapy with Losartan and Trichlormethiazide.

et al. 2003

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Exercise-Induced Acute Renal Failure

Ishikawa¹

2007

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Acute Renal Failure with Severe Loin Pain and Patchy Renal Ischemia after Anaerobic Exercise in Patients with or without Renal Hypouricemia

Ishikawa

2002

Nephron

118

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Acute renal failure induced by rhabdomyolysis after strenuous exercise is well known. We describe here a new type of acute renal failure with severe loin pain which develops after anaerobic exercise (ALPE), for example, 200-meter track racing. The patients complained of severe loin pain several hours after exercise and presented at the emergency room. Since our first description 118 cases have been reported. The serum creatinine concentration was 4.7 ± 2.9 mg/dl (mean ± SD) at the initial examination and 6.0 ± 3.0 mg/dl at maximum. Forty-nine of 96 cases whose serum uric acid levels were described revealed renal hypouricemia (51.0%). A specific risk factor is suggested by the fact that acute renal failure recurred after exercise in 20 of 118 cases. The creatine phosphokinase and serum myoglobin concentrations were normal or only slightly elevated, suggesting damaged type 2 muscle fibers. Renal computed tomography scans, performed several hours to 1–2 days after contrast medium administration, revealed multiple wedge-shaped areas of contrast enhancement. Forty-six of 50 cases examined by delayed computed tomography scan revealed bilateral wedge-shaped contrast enhancement. Although less efficient, radioisotopic scans, such as a methylene diphosphonate bone scan, have also been employed to detect patchy accumulation of isotopes in the kidneys (12 of 19 cases). The pathogenesis of ALPE may be patchy vasoconstriction of the renal vessels, because of its wedge-shaped distribution and its reversibility. Such vascular spasm would account for the renal pain. The prognosis was good, although 20 of 109 cases required dialysis treatment. In conclusion, there are two types of exercise-induced acute renal failure: one is the well-known myoglobin-induced acute renal failure, and the other is ALPE that may be nonmyoglobin induced or induced by myolysis of type 2 muscle fibers due to anaerobic exercise. One hundred and eighteen cases of ALPE were collected from the literature, and half of the cases were found to display renal hypouricemia.

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Acute renal failure after exercise in a patient with renal hypouricemia

Cited by 4 publications

References 18 publications

A Case of Exercise-Induced Acute Renal Failure in a Patient with Idiopathic Renal Hypouricemia Developed during Antihypertensive Therapy with Losartan and Trichlormethiazide.

A Case of Exercise-Induced Acute Renal Failure in a Patient with Idiopathic Renal Hypouricemia Developed during Antihypertensive Therapy with Losartan and Trichlormethiazide.

Exercise-Induced Acute Renal Failure

Acute Renal Failure with Severe Loin Pain and Patchy Renal Ischemia after Anaerobic Exercise in Patients with or without Renal Hypouricemia

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