Abstract
We present two cases of a 12-year-old Japanese boy and a 14-year-old Japanese girl who had exercise-induced acute renal failure (ARF). They experienced general fatigue, nausea/vomiting, and vague discomfort in the abdomen after physical exercise at school. In case of the boy, abdominal pain subsided, but renal dysfunction lasted 17 days, with peak levels of creatinine 9.4 mg/dl and uric acid 11.3 mg/dl. On the other hand, as the girl had suffered from hypouricemia before, she followed a doctor’s guidance on prevention of ARF. Consequently, she was promptly diagnosed as having exercise-induced ARF associated with hypouricemia, and rapidly recovered from ARF within a week. The difference between their clinical courses suggested a possibility that previous laboratory evaluation of serum uric acid assisted in the management of exercise-induced ARF associated with hypouricemia. School-aged children, especially Japanese and Asian, may be advised to have their serum uric acid measured before starting physical training at school.
References
Zager RA (1996) Rhabdomyolysis and myohemoglobinuric acute renal failure. Kidney Int 49:314–326
Ichikawa I (2002) Acute renal failure with sever loin pain and pathy renal ischemia after anaerobic exercise in patients with or without renal hypouricemia. Nephron 91:559–970
Erley CM, Hirschberg RR, Hoefer W, Schaefer K (1989) Acute renal failure due to uric acid nephropathy in a patient with renal hypouricemia. Klin Wochenschr 67:308–312
Igarashi T, Sekine T, Sugimura H, Hayakawa H, Arayama T (1993) Acute renal failure after exercise in a child with renal hypouricaemia. Pediatr Nephrol 7:292–293
Ohta T, Sakano T, Igarashi T, Itami N, Ogawa T (2004) Exercise-induced acute renal failure associated with renal hypouricaemia: results of a questionnaire-based survey in Japan. Nephrol Dial Transplant 19:1447–1453
Sato T, Kuno T, Tashiro K, Fujita I, Miyazaki S (1998) Exercise-induced acute renal failure in a girl with renal hypouricemia. Acta Paediatr Jpn 40:93–95
Murakami T, Kawakami H, Fukuda M, Shiigi H (1993) Recurrence of acute renal failure and renal hypouricaemia. Pediatr Nephrol 7:772–773
Cheong HI, Kang JH, Lee JH, Ha IS, Kim S, Komada F, Sekine T, Igarashi T, Choi Y (2005) Mutational analysis of idiopathic renal hypouricemia in Korea. Pediatr Nephrol 20:886–890
Yeun JY, Hasbargen JA (1995) Renal hypouricemia: prevention of exercise-induced acute renal failure and a review of the literature. Am J Kidney Dis 25:937–946
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Nakamura, A., Niimi, R. & Yanagawa, Y. Renal hypouricemia in school-aged children: screening of serum uric acid level before physical training. Pediatr Nephrol 21, 1898–1900 (2006). https://doi.org/10.1007/s00467-006-0255-7
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DOI: https://doi.org/10.1007/s00467-006-0255-7