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'''For patient information, click [[Acute uric acid nephropathy (patient information)|here]]'''
{{Acute uric acid nephropathy}}
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{{SK}} Acute urate nephropathy
{{SK}} Acute urate nephropathy


==Overview==
==[[Acute uric acid nephropathy overview|Overview]]==


Acute uric acid nephropathy (AUAN) is a rapidly progressive reduction in kidney function ([[renal insufficiency]]) that is caused by high levels of [[uric acid]] in the urine<ref>{{cite journal | author=Conger JD | title=Acute uric acid nephropathy | journal=Med Clin North Am | year=1990 | pages=859-71 | volume=74 | issue=4 }} PMID 2195258<ref/>.
==[[Acute uric acid nephropathy historical perspective|Historical Perspective]]==


==Pathophysiology==
==[[Acute uric acid nephropathy classification|Classification]]==
Acute uric acid nephropathy is caused by deposition of uric acid crystals within the kidney interstitium and tubules, leading to partial or complete obstruction of collecting ducts, renal pelvis, or ureter. This obstruction is usually bilateral, and patients follow the clinical course of [[acute renal failure]].


==Causes==
==[[Acute uric acid nephropathy pathophysiology|Pathophysiology]]==
Acute uric acid nephropathy is usually seen as part of the [[tumor lysis syndrome]] in patients undergoing chemotherapy or radiation therapy for the treatment of malignancies with rapid cell turnover, such as [[leukemia]] and [[lymphoma]]. It may also occur in these patients before treatment is begun, due to spontaneous tumor cell lysis.


Acute uric acid nephropathy can also be caused by an acute attack of [[gout]].
==[[Acute uric acid nephropathy causes|Causes]]==
 
==[[Acute uric acid nephropathy differential diagnosis|Differentiating Acute uric acid nephropathy from other Diseases]]==
 
==[[Acute uric acid nephropathy epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Acute uric acid nephropathy risk factors|Risk Factors]]==
 
==[[Acute uric acid nephropathy screening|Screening]]==
 
==[[Acute uric acid nephropathy natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
The picture of acute renal failure is observed: decreased urine production and rapidly rising serum [[creatinine]] levels. Acute uric acid nephropathy is differentiated from other forms of acute renal failure by the finding of a urine uric acid/creatinine ratio > 1 in a random urine sample.
[[Acute uric acid nephropathy history and symptoms|History and Symptoms]] | [[Acute uric acid nephropathy physical examination|Physical Examination]] | [[Acute uric acid nephropathy laboratory findings|Laboratory Findings]] | [[Acute uric acid nephropathy KUB x ray|KUB X Ray]] | [[Acute uric acid nephropathy CT|CT]] | [[Acute uric acid nephropathy MRI|MRI]] | [[Acute uric acid nephropathy ultrasound|Ultrasound]] | [[Acute uric acid nephropathy other imaging findings|Other Imaging Findings]] | [[Acute uric acid nephropathy other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
===Medical Therapy===
[[Acute uric acid nephropathy medical therapy|Medical Therapy]] | [[Acute uric acid nephropathy surgery|Surgery]] | [[Acute uric acid nephropathy primary prevention|Primary Prevention]] | [[Acute uric acid nephropathy secondary prevention|Secondary Prevention]] | [[Acute uric acid nephropathy cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[Acute uric acid nephropathy future or investigational therapies|Future or Investigational Therapies]]
Treatment is focused on preventing deposition of uric acid within the urinary system by increasing urine volume with potent diuretics such as [[furosemide]]. The urine must also be alkalinized to pH > 7 using sodium bicarbonate and/or [[acetazolamide]] to increase uric acid solubility.


Dialysis (preferably hemodialysis) is started if the above measures fail.
==Case Studies==


==Prevention==
[[Acute uric acid nephropathy case study one|Case #1]]
Patients at risk for acute uric acid nephropathy should be treated with [[allopurinol]] prior to treatment with cytotoxic drugs.


==References==
*
* {{cite journal | author=Robinson RR, Yarger WE | title=Acute uric acid nephropathy | journal=Arch Intern Med | year=1977 | pages=839-40 | volume=137 | issue=7 }} PMID 879920
* {{cite book | author = Yu ASL, Brenner BM | year = 2005 | title = Harrison's Principles of Internal Medicine | chapter = Chapter 266: Tubulointerstitial diseases of the kidney | editor = Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL | edition = 16th edition | publisher =  McGraw-Hill Professional | location = New York}} ISBN 978-0-07-140235-4


[[Category:Disease]]
[[Category:Nephrology]]
[[Category:Nephrology]]


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Latest revision as of 20:44, 30 September 2012

For patient information, click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Acute urate nephropathy

Overview

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Causes

Differentiating Acute uric acid nephropathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

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History and Symptoms | Physical Examination | Laboratory Findings | KUB X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

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