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运动诱发急性肾损伤伴肾性低尿酸血症——一例报告

Renal Hypouricemia with Exercise Induced Acute Kidney Injury-A Case Report.

作者信息

Gundlapalli Srikanth, Gaur Yogesh, Rao M Venkateswar, Bande Sujeeth Reddy, Sandhya P

机构信息

Department of Nephrology, AINU, Hyderabad, Telangana, India.

Department of Anesthesiology, Axon Group, Hyderabad, Telangana, India.

出版信息

Indian J Nephrol. 2021 May-Jun;31(3):307-310. doi: 10.4103/ijn.IJN_127_20. Epub 2020 Nov 19.

Abstract

Acute kidney injury after exercise is most commonly secondary to rhabdomyolysis. Non-rhabdomyolysis AKI is secondary to a limited number of disorders of which renal hypouricemia (RHUC) needs a special mention. It is relatively a rare genetic disorder and is reported in Japanese and Ashkenazi Jews. Humans have lost the ability to metabolize uric acid as the "uricase" gene is suppressed. Renal tubules handle uric acid and aid in maintaining serum concentrations in the soluble range. Uric acid excretion is increased in RHUC patients due to proximal tubular defects. This leads to the loss of antioxidant capabilities of the kidney, predisposing them to severe AKI following anaerobic exercise. We report a case of exercise-induced AKI secondary to renal hypouricemia.

摘要

运动后急性肾损伤最常见的继发原因是横纹肌溶解症。非横纹肌溶解症所致急性肾损伤继发于少数几种疾病,其中肾性低尿酸血症(RHUC)值得特别提及。它是一种相对罕见的遗传性疾病,在日本人和德系犹太人中有所报道。由于“尿酸酶”基因受到抑制,人类失去了代谢尿酸的能力。肾小管处理尿酸并有助于将血清浓度维持在可溶范围内。由于近端肾小管缺陷,RHUC患者的尿酸排泄增加。这导致肾脏抗氧化能力丧失,使他们在无氧运动后易发生严重急性肾损伤。我们报告一例继发于肾性低尿酸血症的运动诱发急性肾损伤病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c2d/8330661/c80cfb262768/IJN-31-307-g001.jpg

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