2013年5月27日星期一

How Do You Get Acute Uric Acid Nephropathy


Acute Uric Acid Nephropathy refers to kidney function decreases rapidly caused by high levels of uric acid in the urine. How do you get Acute Uric Acid Nephropathy and how to prevent it? This article will give you a clear response.

It is very common among the patients with myeloproliferative disorders and malignant tumor, especially after chemotherapy. Acute Uric Nephropathy is caused by renal tubular obstruction by urate and uric acid crystal. Under the influence of chemotherapeutic agents or radiation therapy, a lot of nucleotides are dissolved and cell lysis occurs. As a result, the uric acid level rises in a short time and may exceed 1000 umol/l. When the high uric acid level exceeds the clearance ability of kidneys, the uric acid crystals will deposit in collecting duct, pelvis and even ureter.

The crystal deposition causes increased tubular pressure, increased intrarenal pressure and extrinsic compression of the small diameter renal venous network. As a result, the resistance in renal vessels increases and the renal blood flow decreases. The increased tubular pressure and declined renal blood flow cause a decline in glomerular filtration and lead to oligoanuric Acute Renal Failure.

In order to avoid Acute Uric Acid Nephropathy, the patients with leukemia, lymphoma, multiple myeloma and other malignant tumor should take allopurinol before undergoing chemotherapy. In chemotherapy, they should keep enough water intakes and guarantee their urine output volume reaches 2000~3000 ml per day. Moreover, they should alkalify urine. If necessary, they should take some diuretic to increase the urine output.

Moreover, in some cases, acute gout also can lead to Acute Uric Acid Nephropathy. If you have a prehistory of acute gout and have abnormal symptoms like decreased urine output, you should go to relative exam to find if you have renal injury.

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