title: Two cases of renal hypouricemia in which dopamine infusion produced a good recovery from exercise-induced acute kidney injury.
abstract: We report 2 cases with a good recovery from acute kidney injury (AKI) due to exercise-induced AKI associated with renal hypouricemia. Case 1 involves a 20-yearold man who had a similar episode 1 year earlier. He complained of nausea, vomiting and loin pain after playing football. On admission, his serum creatinine was 3.27 mg/dl and he was treated with intravenous fluid infusion (2 l/d). His renal function deteriorated and creatinine rose to 9.82 mg/dl. A renal hemodynamic evaluation using duplex Doppler ultrasound showed a high arterial resistance index (RI). After we changed his treatment to intravenous continuous infusion of 2 µg/kg/min dopamine, RI decreased sequentially and creatinine decreased without hemodialysis. A renal biopsy performed 7 days after dopamine infusion showed no changes in glomeruli and tubules, suggesting the absence of acute tubular necrosis, and no uric acid crystals or myoglobin casts in tubules. Case 2 involves a 42-year-old man who complained of loin pain after riding a motorcycle. On admission, his creatinine and creatine phosphokinase (CPK) were 3.93 mg/dl and 59 mU/ml, respectively. His RI was also high and he was treated immediately with an intravenous continuous infusion of 2 µg/kg/min dopamine. RI and creatinine decreased sequentially. Both cases suggest the effectiveness of dopamine infusion for AKI due to renal hypouricemia in which the RI of the renal arteries is high.
authors.affiliation: Division of Nephrology, Department of Medicine, Jichi Medical University, Tochigi, Japan. nephsait@hichi.ac.jp
authors.forename: O
authors.initials: O
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Sugase
authors.forename: T
authors.initials: T
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Akimoto
authors.forename: M
authors.initials: M
authors.lastname: Inoue
authors.forename: Y
authors.initials: Y
authors.lastname: Ando
authors.forename: S
authors.initials: S
authors.lastname: Muto
authors.forename: E
authors.initials: E
authors.lastname: Kusano
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000328:Adult; D004298:Dopamine / Q000627:therapeutic use*; D015259:Dopamine Agents / Q000627:therapeutic use*; D015444:Exercise; D006801:Humans; D008297:Male; D009399:Nephrons / Q000473:pathology; D012077:Renal Artery / Q000502:physiology; D015499:Renal Tubular Transport, Inborn Errors / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000150:complications / Q000188:drug therapy*; D014655:Vascular Resistance; D055815:Young Adult
chemical_list: D015259:Dopamine Agents; D004298:Dopamine