Efficacy of urate oxidase (uricozyme) in tumour lysis induced urate nephropathy.
Urate oxidase (uricozyme) is an enzyme of non-human origin capable of oxidizing human uric acid to allantoin, a highly soluble product at renal tubule pH. We report its efficacy in three patients with acute urate nephropathy due to tumour lysis in chronic lymphatic leukaemia and high grade lymphoma. Two patients had an additional obstructive nephropathy due to ureteric urate crystals. An intravenous infusion (100 units/kg in 50 ml saline over 30 min) was given for between two and five consecutive days. All patients showed a rapid fall in serum urate levels with associated diuresis, correction of metabolic disturbance and full resolution of uraemia within a week. The treatment was well tolerated and caused a rapid resolution of clinical symptoms in all cases. We review the literature relating to the use of this agent both in the treatment of hyperuricaemic acute renal failure and gouty arthritis.
Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
M
M
Leach
R M
RM
Parsons
J T
JT
Reilly
D A
DA
Winfield
D000368:Aged; D000481:Allantoin / Q000378:metabolism; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D004231:Diuresis / Q000187:drug effects; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000188:drug therapy / Q000209:etiology; D007674:Kidney Diseases / Q000188:drug therapy* / Q000209:etiology; D007684:Kidney Tubules / Q000378:metabolism; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009846:Oliguria / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D015275:Tumor Lysis Syndrome / Q000188:drug therapy*; D014503:Urate Oxidase / Q000627:therapeutic use*; D014527:Uric Acid / Q000378:metabolism*; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000964:Antimetabolites, Antineoplastic; D014527:Uric Acid; D000481:Allantoin; D014503:Urate Oxidase; D014740:Vidarabine; C024352:fludarabine