Nakamura Akio, Niimi Ryo, Yanagawa Yukishige
Department of Paediatrics, Teikyo University School of Medicine, 2-11-1 Kaga, Tokyo 173, Japan.
Pediatr Nephrol. 2006 Dec;21(12):1898-900. doi: 10.1007/s00467-006-0255-7. Epub 2006 Sep 6.
We present two cases of a 12-year-old Japanese boy and a 14-year-old Japanese girl who had exercise-induced acute renal failure (ARF). They experienced general fatigue, nausea/vomiting, and vague discomfort in the abdomen after physical exercise at school. In case of the boy, abdominal pain subsided, but renal dysfunction lasted 17 days, with peak levels of creatinine 9.4 mg/dl and uric acid 11.3 mg/dl. On the other hand, as the girl had suffered from hypouricemia before, she followed a doctor's guidance on prevention of ARF. Consequently, she was promptly diagnosed as having exercise-induced ARF associated with hypouricemia, and rapidly recovered from ARF within a week. The difference between their clinical courses suggested a possibility that previous laboratory evaluation of serum uric acid assisted in the management of exercise-induced ARF associated with hypouricemia. School-aged children, especially Japanese and Asian, may be advised to have their serum uric acid measured before starting physical training at school.
我们报告了两例运动诱发急性肾衰竭（ARF）的病例，患者分别是一名12岁的日本男孩和一名14岁的日本女孩。他们在学校体育锻炼后出现全身乏力、恶心/呕吐以及腹部隐痛不适。在男孩的病例中，腹痛缓解，但肾功能障碍持续了17天，肌酐峰值水平为9.4mg/dl，尿酸峰值水平为11.3mg/dl。另一方面，由于女孩之前患有低尿酸血症，她遵循了医生关于预防ARF的指导。因此，她被迅速诊断为运动诱发的与低尿酸血症相关的ARF，并在一周内迅速从ARF中康复。他们临床病程的差异表明，先前对血清尿酸的实验室评估可能有助于管理与低尿酸血症相关的运动诱发ARF。对于学龄儿童，尤其是日本和亚洲儿童，建议在开始学校体育训练前检测血清尿酸。
