An important complication of idiopathic renal hypouricemia is exercise-induced acute renal failure (ARF). The most plausible explanation for this complication is that decreased antioxidant potential leads to kidney injury by reactive oxygen species (ROS). We demonstrated this oxidative imbalance by a concomitant assessment of ROS production and antioxidant system capability in a 15- year-old girl with idiopathic renal hypouricemia caused by a mutation in the urate transporter (URAT1) gene. Her serum level of ROS increased with decreasing antioxidant potential capacity soon after the initiation of anaerobic stress due to treadmill exercise. Thereafter, serum levels of ROS and antioxidant potential showed a parallel course, returning to the baseline values at 240 min after exercise. Some patients with idiopathic renal hypouricemia demonstrate oxidative imbalance soon after exercise with a predisposition to exercise-induced acute renal failure. Antioxidant properties may alter this imbalance by augmenting the antioxidant activity.
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Hisatome I, Ogino K, Kotake H, Ishiko R, Saito M, Hasegawa J, Mashiba H, Nakamoto S (1989) Cause of persistent hypouricemia in outpatients. Nephron 51:13–16
Sperling O (1992) Renal hypouricemia: classification, tubular defect and clinical consequences. Contrib Nephrol 100:1–14
Enomoto A, Kimura H, Chairoungdua A, Shigeta Y, Jutabha P, Cha SH, Hosoyamada M, Takeda M, Sekine T, Igarashi T, Matsuo H, Kikuchi Y, Oda T, Ichida K, Hosoya T, Shimokata K, Niwa T, Kanai Y, Endou H (2002) Molecular identification of a renal urate anion exchanger that regulates blood urate levels. Nature 23:447–452
Tanaka M, Itoh K, Matsushita K, Matsushita K, Wakita N, Adachi M, Nonoguchi H, Kitamura K, Hosoyamada M, Endou H, Tomita K (2003) Two male siblings with hereditary renal hypouricemia and exercise-induced ARF. Am J Kidney Dis 42:1287–1292
Ishikawa I, Nakagawa M, Hayama S, Yoshida S, Date T (2005) Acute renal failure with severe loin pain and patchy renal ischaemia after anaerobic exercise (ALPE) (exercise-induced acute renal failure) in a father and child with URAT1 mutations beyond the W258X mutation. Nephrol Dial Transplant 20:1015
Ito O, Hasegawa Y, Sato K, Mitsui H, Yuda F, Sato H, Ito S, Kudo K (2003) A case of exercise-induced acute renal failure in a patient with idiopathic renal hypouricemia developed during antihypertensive therapy with losartan and trichlormethiazide. Hypertens Res 26:509–513
Ohta T, Sakano T, Igarashi T, Itami N, Ogawa T, ARF Assocoated with Renal Hypouricemia Research Group (2004) Exercise-induced acute renal failure associated with renal hypouricaemia: results of a questionnaire-based survey in Japan. Nephrol Dial Transplant 19:1447–1453
Ichida K, Hosoyamada M, Hisatome I, Enomoto A, Hikita M, Endou H, Hosoya T (2004) Clinical and molecular analysis of patients with renal hypouricemia in Japan-influence of URAT1 gene on urinary urate excretion. J Am Soc Nephrol 15:164–173
Murakami T, Kawakami H, Fukuda M, Furukawa S (1995) Patients with renal hypouricemia are prone to develop acute renal failure–why? Clin Nephrol 43:207–208
Ames BN, Cathcart R, Schwiers E, Hochstein P (1981) Uric acid provides an antioxidant defense in humans against oxidant and radical caused aging and cancer: a hypothesis. Proc Natl Acad Sci USA 78:6858–6862
Pasquini A, Luchetti E, Marchetti V, Cardini G, Iorio EL (2008) Analytical performances of d-ROMs test and BAP test in canine plasma. Definition of the normal range in healthy Labrador dogs. Vet Res Commun 32:137–143
Cornelli U, Terranova R, Luca S, Cornelli M, Alberti A (2001) Bioavailability and antioxidant activity of some food supplements in men and women using the D-Roms test as a marker of oxidative stress. J Nutr 131:3208–3211
Dohi K, Satoh K, Ohtaki H, Shioda S, Miyake Y, Shindo M, Aruga T (2005) Elevated plasma levels of bilirubin in patients with neurotrauma reflect its pathophysiological role in free radical scavenging. In Vivo 19:855–860
Iamele L, Fiocchi R, Vernocchi A (2002) Evaluation of an automated spectrophotometric assay for reactive oxygen metabolites in serum. Clin Chem Lab Med 40:673–676
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
Kerksick C, Taylor L 4th, Harvey A, Willoughby D (2008) Gender-related differences in muscle injury, oxidative stress, and apoptosis. Med Sci Sports Exerc 40:1772–1780
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Kaneko, K., Taniguchi, N., Tanabe, Y. et al. Oxidative imbalance in idiopathic renal hypouricemia. Pediatr Nephrol 24, 869–871 (2009). https://doi.org/10.1007/s00467-008-1032-6
- Exercise-induced acute renal failure
- Idiopathic renal hypouricemia
- Oxidative stress
- Urate transport