title: Recurrent exercise-induced acute renal failure in renal hypouricemia.
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.
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ninomiya
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
authors.forename: A
authors.initials: A
authors.lastname: Nishi
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: A
authors.initials: A
authors.lastname: Koga
authors.forename: Y
authors.initials: Y
authors.lastname: Hori
authors.forename: H
authors.initials: H
authors.lastname: Nishida
authors.forename: G
authors.initials: G
authors.lastname: Nomura
authors.forename: H
authors.initials: H
authors.lastname: Kato
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology; D000293:Adolescent; D015444:Exercise / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007687:Kidney Tubules, Proximal / Q000378:metabolism; D008297:Male; D012008:Recurrence; D014527:Uric Acid / Q000097:blood* / Q000378:metabolism; D014661:Vasoconstriction
chemical_list: D014527:Uric Acid