The characteristic pattern of aminoaciduria in patients with aristolochic acid-induced Fanconi syndrome: could iminoaciduria be the hallmark of this syndrome?
BACKGROUND
In Japan the patients with Chinese herbs nephropathy (CHN), aristolochic acids-(AAs) associated renal failure, often present Fanconi syndrome. The aim of this study was to investigate the pattern of aminoaciduria in patients with AAs-induced Fanconi syndrome and to clarify whether it is different from other Fanconi syndromes reported in the literature.


METHODS
The subjects consisted of 4 patients with Fanconi syndrome due to AAs. We studied biochemical data and urinary excretion of amino acids in the 4 patients. Amino acids in their urine were analyzed by high performance liquid chromatography (HPLC).


RESULTS
Three out of 4 patients showed in common very increased excretion ofproline, hydroxyproline and citruline. Last patient showed the very increased levels of proline and valine. Regarding glycine, which is considered to belong to the same group as imino acid and to be shared with high-affinity transport system ofproline, there was not very increased excretion.


CONCLUSIONS
These findings suggest that AAs would predominantly affect the low-affinity transport system of proline in the brushborder membrane of proximal tubules because the low-affinity system is considered not to be shared with glycine transport.
Tanaka
A
A
Department of Nephrology, Saiseikai Nakatsu Hospital, Osaka, Japan.
Nishida
R
R
Yokoi
H
H
Kuwahara
T
T
D000328:Adult; D000596:Amino Acids / Q000652:urine*; D034341:Aristolochic Acids; D005198:Fanconi Syndrome / Q000139:chemically induced* / Q000652:urine*; D005260:Female; D006801:Humans; D007098:Imino Acids / Q000652:urine*; D008297:Male; D010616:Phenanthrenes / Q000009:adverse effects*
D000596:Amino Acids; D034341:Aristolochic Acids; D007098:Imino Acids; D010616:Phenanthrenes; C000228:aristolochic acid I