acute uric acid nephropathy
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Etiology
- tumor lysis syndrome after chemotherapy
- myeloproliferative disorders
- heat stroke
- status epilepticus
- Lesch-Nyhan syndrome
Pathology
- intraluminal crystals cause intrarenal obstruction
- concurrent hypertension, ischemia or poorly-controlled diabetes accompany tubulointerstitial damage in patients with hyperuricemia
Laboratory
- serum uric acid often > 15 mg/dL
- 24 hour urine uric acid > 1 gram
- spot urine uric acid/creatinine is often > 1.0
Differential diagnosis
- lead nephropathy
- de novo gout in renal failure is rare
- patient has lead nephropathy until proven otherwise
Management
- prevention:
- treatment: dialysis
- prognosis: condition is generally reversible