Unmasking the silent culprit: recurrent exercise-induced acute kidney injury in a Chinese adolescent with renal hypouricemia

Ren Fail. 2024 Dec;46(2):2373271. doi: 10.1080/0886022X.2024.2373271. Epub 2024 Aug 6.

Abstract

Primary renal hypouricemia (RHUC) is a rare autosomal recessive disorder with a mean duration of end-stage acute kidney injury (EIAKI) of 14 days. The pathogenesis of EIAKI in patients with RHUC remains unclear. Several hypotheses have been proposed, including those related to the renal vasoconvulsive effect and the elevating effect of xanthine oxidase (XO). The effect of xanthine oxidase (XO) is most often observed following strenuous anaerobic exercise, which is frequently accompanied by low back pain, nausea, and acute kidney injury (AKI). Consequently, we postulate that EIAKI could be prevented by avoiding strenuous exercise, thus preventing the onset and recurrence of EIAKI. In this paper, we present a case of recurrent EIAKI in a patient with RHUC and a mutation in the SLC2A9 gene.

Keywords: EIAKI; Kidney; RHUC; SLC2A9 gene; autosomal recessive disorder; biopsy.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury* / etiology
  • Adolescent
  • China
  • East Asian People
  • Exercise*
  • Glucose Transport Proteins, Facilitative / genetics
  • Humans
  • Male
  • Mutation
  • Recurrence
  • Renal Tubular Transport, Inborn Errors* / complications
  • Renal Tubular Transport, Inborn Errors* / genetics
  • Urinary Calculi / complications
  • Urinary Calculi / etiology
  • Urinary Calculi / genetics
  • Xanthine Oxidase

Substances

  • Glucose Transport Proteins, Facilitative
  • SLC2A9 protein, human
  • Xanthine Oxidase

Supplementary concepts

  • Renal hypouricemia