CLINICAL STUDIES OF HYPERURICEMIA

I. Clinical Observation and Treatment of Acute Uric Acid Nephropathy

Abstract

Renal failure due to hyperuricemia has been known to develop not only as a result of gout but also during the course of therapy of leukemia and malignant lymphoma.
We have recently experienced the ocurrence of acute renal failure in our urological cases postoperatively and/or during radiation-therapy, the causes of which could be attributed to hyperuricemia.
Here we presented eight cases of “acute uric acid nephropathy” (4 cases of prostatic cancer, 3 cases of bladder cancer, and 1 case of ureteral stone).
Our observation and analysis of these cases yielded the following findings. (1) Increase of both serum and urinary uric acid was noted postoperatively and after initiation of radiation-therapy, along with progression of renal failure as represented by azotemia. (2) Administration of “allopurinol” (xanthine oxidase inhibitor) relieved the abnormal uric acid metabolism as well as renal failure. (3) Development of acute uric acid nephropathy in these cases is considered to be a result of accumulation of numerous predisposing factors to increase uric acid production, such as surgical intervention, irradiation, use of inosine, and presence of malignant tumors, under the circumstance enough to disturb uric acid excretion such as impaired renal function.
We thus emphasize the necessity of recognizing development of “acute uric acid nephropathy” whenever production of uric acid prevails under impaired renal function, and also clinical significance of the use of “allopurinol” for relief of this nephropathy.