肾性低尿酸血症中复发性运动诱发的急性肾衰竭

Recurrent exercise-induced acute renal failure in renal hypouricemia.

作者信息

Ninomiya M, Ito Y, Nishi A, Matsumoto T, Koga A, Hori Y, Nishida H, Nomura G, Kato H

机构信息

Department of Pediatrics and Child Health, Kurume University School of Medicine, Japan.

出版信息

Acta Paediatr. 1996 Aug;85(8):1009-11. doi: 10.1111/j.1651-2227.1996.tb14206.x.

DOI:10.1111/j.1651-2227.1996.tb14206.x

PMID:8863890

Abstract

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 (0.4 mg dl-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 presecretory 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.

摘要

我们描述了一名男性患者，他在14岁至25岁之间剧烈运动后出现了4次急性肾衰竭。发现他血清尿酸水平较低（恢复后为0.4mg/dl），尿酸排泄分数较高。苯溴马隆/吡嗪酰胺试验表明，肾性低尿酸血症是由于尿酸在分泌前部位近端肾小管重吸收缺陷所致。肾活检显示急性肾小管坏死，肾脏计算机断层扫描显示斑片状对比增强，跑步机运动试验导致肌酐清除率立即下降。这些发现提示急性肾衰竭的原因是肾血管收缩而非尿酸结晶阻塞。