The Case ∣ A young man with acute kidney injury after exercise

Yan, Ming-Tso; Cheng, Changming; Chen, Jin‐Shuen; Lin, Shih‐Hua

doi:10.1038/ki.2009.563

Cited by 19 publications

(6 citation statements)

References 6 publications

(10 reference statements)

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“…It was preferable to perform contrast media-enhanced CT, in order to identify severe vasoconstriction in the kidneys as wedge-shaped defects. Since he had stage 3 AKI (KDIGO), we did not attempt to perform enhanced CT and selected the term “EAKI” [4, 25].…”

Section: Discussionmentioning

confidence: 99%

“…One month later, the urinary findings and renal function returned to normal. The serum uric acid was 0.5 mg/dL and fractional excretion of uric acid was 82%, suggesting that he was also exhibiting renal hypouricemia and that this episode was due to EAKI in hereditary renal hypouricemia [4].…”

Section: Case Reportmentioning

confidence: 99%

“…While most patients are asymptomatic, episodes of the urolithiasis and exercise-induced acute kidney injury (EAKI) are sometimes observed [3, 4]. The increased risk of urolithiasis is due to hyperuricosuria and hypercalciuria [5].…”

Section: Introductionmentioning

confidence: 99%

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Exercise-Induced Acute Kidney Injury in a Police Officer with Hereditary Renal Hypouricemia

Shimizu

Wakabayashi

Totsuka

et al. 2019

Case Rep Nephrol Dial

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Hereditary renal hypouricemia is characterized by hypouricemia with hyper-uric acid clearance due to a defect in renal tubular transport. Patients with hereditary renal hypouricemia have a higher risk of exercise-induced acute kidney injury (EAKI) and reduced kidney function. Although the best preventive measure is avoiding exercise, there are many kinds of jobs that require occupational exercise. A 27-year-old male police officer suffered from stage 3 AKI after performing a 20-m multistage shuttle run test. His mother had previously been diagnosed as having renal hypouricemia at another facility. The patient had reported having hypouricemia during a health check at a previous police station, but his serum uric acid concentration was within the normal range at our hospital. After treatment, he recovered from EAKI and exhibited low serum uric acid and hyper-uric acid clearance. Since the patient desired to continue his career requiring strenuous exercise, it was difficult to establish a preventive plan against the recurrence of EAKI. Patients with hereditary renal hypouricemia who must undergo strenuous occupational anaerobic exercise are at higher risk of developing EAKI than other workers. The risks of EAKI among patients with hypouricemia should be considered when undergoing physical occupational training.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

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Exercise-Induced Acute Kidney Injury in a Police Officer with Hereditary Renal Hypouricemia

Shimizu

Wakabayashi

Totsuka

et al. 2019

Case Rep Nephrol Dial

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“…[16] Some studies suggested that the brain edema might be a result rather than the cause of generalized vasoconstriction in PRES patients and PRES complicated with end organ dysfunction such as acute kidney injury had been described previously. [28–30] Our patient also had acute kidney injury and liver impairment just before the onset of PRES. These findings correlated the hypothesis of hypoperfusion and it might play an essential role in occurrence of PRES in our postpartum hemorrhagic patient.…”

Section: Discussionmentioning

confidence: 85%

Posterior reversible encephalopathy syndrome in a postpartum hemorrhagic woman without hypertension

et al. 2017

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Rationale:Posterior reversible encephalopathy syndrome (PRES), which diagnosis is based on clinical symptoms and radiological features, is a neurotoxic disease characterized by a set of clinical manifestations, such as seizure, headache, visual, and/or consciousness disturbance. It is the first case of PRES followed by postpartum hemorrhage (PPH) without underlying disease.Patient concerns:A 37-year-old healthy woman had PPH after caesarean section. Six days after delivery, headache occurred suddenly, followed by episodes of clonus seizure.Diagnoses:Brain computed tomography showed ischemic stroke. However, magnetic resonance imaging revealed characteristics consistent with PRES.Interventions:The patient received phenytoin for seizure control.Outcomes:Seizure was under good control over the following days. Three months later, repeated magnetic resonance imaging showed complete remission.Lessons:PRES may be triggered by PPH and is not necessarily secondary to typical predisposing factors such as hypertension or pre/eclampsia. Hormone fluctuation, increased blood pressure variation, and massive blood transfusion may be contributed to the development of PRES in our case. Also, it is necessary to rule out those life-threatening diseases, such as cavernoma hemorrhage, cerebral venous thrombosis, and ischemic stroke before the diagnosis of PRES.

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“…As in Caucasians, Israel-Arab, Iraqi jews (Zhou et al, 2018), Pakistan (Jeannin et al, 2014) and India (Chakraborty & Sural, 2013), scattered hypouricemia cases have also been reported in China which displayed dispersed mutation spectrum. For example, homozygous SLC22A12: p.R90H was found in two brothers with hypouricemia (Yan, Cheng, Chen, & Lin, 2010), compound heterozygous SLC22A12: p.P78L plus p.Q382L (Lam et al, 2008), homozygous SLC2A9: p.W238X (Shen et al, 2014), homozygous splicing mutation c.1215+1 G>A in SLC2A9 (Mou, Jiang, & Hu, 2015), and compound heterozygous SLC22A12: p.R90H plus p.M430fsX466 (Zhou et al, 2018) were found in each hypouricemia patient, respectively. In another literature, three hypouricemia siblings and their normal father had heterozygous SLC22A12: p.A51fsX64 (Li et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Amplicon targeted resequencing for SLC2A9 and SLC22A12 identified novel mutations in hypouricemia subjects

Zhou

Wang

Zhou

et al. 2019

Molec Gen & Gen Med

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Background To identify potential causative mutations in SLC2A9 and SLC22A12 that lead to hypouricemia or hyperuricemia (HUA). Methods Targeted resequencing of whole exon regions of SLC2A9 and SLC22A12 was performed in three cohorts of 31 hypouricemia, 288 HUA and 280 normal controls. Results A total of 84 high‐quality variants were identified in these three cohorts. Eighteen variants were nonsynonymous or in splicing region, and then included in the following association analysis. For common variants, no significant effects on hypouricemia or HUA were identified. For rare variants, six single nucleotide variations (SNVs) p.T21I and p.G13D in SLC2A9 , p.W50fs, p.Q382L, p.V547L and p.E458K in SLC22A12, occurred in totally six hypouricemia subjects and were absent in HUA and normal controls. Allelic and genotypic frequency distributions of the six SNVs differed significantly between the hypouricemia and normal controls even after multiple testing correction, and p.G13D in SLC2A9 and p.V547L in SLC22A12 were newly reported. All these mutations had no significant effects on HUA susceptibility, while the gene‐based analyses substantiated the significant results on hypouricemia. Conclusion Our study first presents a comprehensive mutation spectrum of hypouricemia in a large Chinese cohort.

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The Case ∣ A young man with acute kidney injury after exercise

Cited by 19 publications

References 6 publications

Exercise-Induced Acute Kidney Injury in a Police Officer with Hereditary Renal Hypouricemia

Exercise-Induced Acute Kidney Injury in a Police Officer with Hereditary Renal Hypouricemia

Posterior reversible encephalopathy syndrome in a postpartum hemorrhagic woman without hypertension

Amplicon targeted resequencing for SLC2A9 and SLC22A12 identified novel mutations in hypouricemia subjects

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