RECURRENT EXERCISE-INDUCED ACUTE-RENAL-FAILURE IN RENAL HYPOURICEMIA

We describe a male patient with four episodes of acute renal failure a fter strenuous exercise occurring between the age of 14 and 25 years. He was found to have low serum uric acid (0.4 mg dl(-1) after recovery ) and high fractional excretion of uric acid. A benzbromarone/pyrazina mide test suggested that renal hypouricemia was due to defective proxi mal tubular reabsorption of uric acid at a presecretory site. A renal biopsy revealed acute tubular necrosis, a renal computer tomography sc an showed patchy contrast enhancement and a treadmill exercise test in duced an immediate fall in creatinine clearance. These findings sugges t that the cause of acute renal failure was renal vasoconstriction rat her than obstruction by uric acid crystals.