Acute uric acid nephropathy

Acute uric acid nephropathy (AUAN) is a medical condition characterized by the rapid onset of kidney failure due to high levels of uric acid in the kidneys. This condition is most commonly associated with chemotherapy or radiation therapy for cancer, but can also occur in individuals with a high purine diet or certain genetic disorders.

Causes

The primary cause of AUAN is the rapid breakdown of cells, which releases large amounts of nucleic acids into the bloodstream. These nucleic acids are then metabolized into uric acid, which can crystallize in the kidneys if produced in large enough quantities. This can lead to kidney damage and, in severe cases, kidney failure.

Chemotherapy and radiation therapy for cancer are the most common causes of this rapid cell breakdown, but other conditions that cause rapid cell turnover, such as gout, psoriasis, and hemolytic anemia, can also lead to AUAN.

Symptoms

The symptoms of AUAN can vary depending on the severity of the condition. In mild cases, individuals may experience fatigue, nausea, and vomiting. In more severe cases, individuals may develop oliguria (reduced urine output), anuria (absence of urine output), and signs of kidney failure.

Diagnosis

AUAN is typically diagnosed through a combination of blood tests, urine tests, and imaging studies. Blood tests may reveal high levels of uric acid and creatinine, while urine tests may show the presence of uric acid crystals. Imaging studies, such as ultrasound or computed tomography (CT) scans, can reveal the size and shape of the kidneys and any blockages in the urinary tract.

Treatment

The primary treatment for AUAN is to address the underlying cause of the high uric acid levels. This may involve adjusting the dosage or timing of chemotherapy or radiation therapy, treating the underlying condition causing rapid cell turnover, or modifying the individual's diet to reduce purine intake.

In addition to addressing the underlying cause, treatment may also involve measures to reduce the uric acid levels in the blood and prevent further kidney damage. This can include hydration therapy, alkalinization of the urine, and medications to lower uric acid levels, such as allopurinol or rasburicase.

See also

• Chronic kidney disease
• Hyperuricemia
• Tumor lysis syndrome