Acute renal failure after exercise in a Japanese sumo wrestler with renal hypouricemia.

Abstract

Familial renal hypouricemia is a hereditary disease characterized by extraordinary high renal uric acid clearance and is associated with acute renal failure (ARF). An 18-year-old sumo wrestler developed ARF after anaerobic exercise. Several hours after the exercise, he had a pain in the loins with oliguria, headache, and nausea. On admission, his serum uric acid was decreased despite the elevation of serum creatinine (9.5 mg/dL). The level of creatine kinase was normal and there was no myoglobinuria or urolithiasis. Magnetic resonance imaging showed no significant abnormality. Renal function improved completely within 2 weeks of hydration treatment. After remission, hypouricemia became obvious (1.0 mg/dL) from the initial level of uric acid (6.1 mg/dL) and fractional excretion of uric acid was 49%. Polymerase chain reaction of a urate anion exchanger known to regulate blood urate level (SLC22A12 gene: URAT1) demonstrated that homozygous mutations in exon 4 (W258X). Both parents showed heterozygous mutation of the URAT1 gene, but both siblings showed no mutation. Thus, we describe a Japanese sumo wrestler of familial renal hypouricemia complicated with anaerobic exercise-induced ARF, with definite demonstration of genetic abnormality in the responsible gene, URAT1.

• Authors: Akira Mima, Kimiyoshi Ichida, Takeshi Matsubara, Hiroshi Kanamori, Emi Inui, Misa Tanaka, Yumi Manabe, Noriyuki Iehara, Yoshinori Tanaka, Motoko Yanagita, Atsuko Yoshioka, Hidenori Arai, Masashi Kawamura, Katsumasa Usami, Tatsuo Hosoya, Toru Kita, Atsushi Fukatsu
• Journal: The American journal of the medical sciences (Am J Med Sci) Vol. 336 Issue 6 Pg. 512-4 (Dec 2008) ISSN: 0002-9629 [Print] United States
• PMID: 19092327 (Publication Type: Case Reports, Journal Article)

Chemical References

• Organic Anion Transporters
• Organic Cation Transport Proteins
• SLC22A12 protein, human
• Uric Acid

Topics

• Acute Kidney Injury (etiology, physiopathology)
• Adolescent
• DNA Mutational Analysis
• Exercise
• Female
• Humans
• Japan
• Male
• Organic Anion Transporters (genetics)
• Organic Cation Transport Proteins (genetics)
• Pedigree
• Uric Acid (blood)
• Wrestling