Exercise-Induced Acute Renal Failure: Acute Renal Failure with Severe Loin Pain and Patchy Renal Ischemia after Anaerobic Exercise

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Springer Science & Business Media, Feb 1, 2008 - Medical - 108 pages
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Acute renal failure induced by rhabdomyolysis after strenuous, prolonged exercise such as marathon running or mountain climbing is a well-known medical phenomenon, but exercise-induced acute renal failure after short-term anaerobic exercise - for instance, short-distance track races - has been recognized only recently. This monograph provides in-depth information on exercise-induced acute renal failure after short-term anaerobic exercise, which causes severe pain in the loin and patchy renal ischemia with no sign of rhabdomyolysis. Half of the patients suffering from this condition experience renal hypouricemia, for which approximately 20% are treated with dialysis. This complete clinical reference book includes characteristics of the disease, diagnosis, treatment and prognosis, and corresponding preventive measures. Important information on gene analysis and etiology is also included, creating a valuable resource for nephrologists as well as for emergency physicians and those in the field of sports medicine.

 

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Contents

ExerciseRelated Acute Renal Failure
1
ExerciseInduced Acute Renal Failure ALPE
3
WedgeShaped Patchy Renal Ischemia
9
2 Interpretation of WedgeShaped Renal Lesions
11
3 Administration of Contrast Medium in the Presence of Acute Renal Failure
13
4 Visualization of WedgeShaped Lesions by Bone Scan with MDP and MRI
14
Definition of ExerciseInduced Acute Renal Failure ALPE
17
2 Nontypical Cases
19
Gene Analysis of Uric Acid Transporter URAT1
58
Risk Factors Other than Renal Hypouricemia
65
EtiologyPathogenesis
67
3 Investigation of Oxidative Stress Markers
70
5 Preparation of WedgeShaped Patchy Renal Ischemia in an Animal Experiment
73
62 Involvement of active oxygen and various vasoactive substances
74
Diagnosis
75
4 Necessity of Visualizing WedgeShaped Patchy Renal Ischemia
79

Our Series 22 Patients
21
2 Delayed CT MRI and Bone Scan with MDP
41
Summary of 155 Cases Collected from the Literature
43
3 Renal Hypouricemia
46
5 Kidney Biopsy
47
Exercise
49
3 Involvement of Type II Muscle Fibers
51
Loin Pain
52
3 Mechanism Involved in Pain
53
Renal Hypouricemia
54
3 Reasons for a High Incidence of ALPE in Patients with Renal Hypouricemia
56
Treatment
81
Disease Course and Prognosis
83
Prevention
85
Conclusions
87
Postscript
89
Acknowledgments
91
Brief History of the Author
93
References
95
Index
105
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Page 103 - Fletcher P, Al-Khader AA, Parsons V, Aber GM (1979) The pathology of intrarenal vascular lesions associated with the loin-pain-haematuria syndrome. Nephron 24:150-154 149.
Page 98 - Yeun JY, Hasbargen JA: Renal hypouricemia: Prevention of exercise-induced acute renal failure and a review of the literature. Am J Kidney Dis 1995;25:937-946.
Page 102 - Leech RW (1992) Rhabdomyolysis in childhood. A primer on normal muscle function and selected metabolic myopathies characterized by disordered energy production. Pediatr Clin North Am 39:821-858 142.
Page 101 - Tanaka M, Itoh K, Matsushita K, Matsushita K, Wakita N, Adachi M, Nonoguchi H, Kitamura K, Hosoyamada M, Endou H, Tomita K (2003) Two male siblings with hereditary renal hypouricemia and exercise-induced ARF.

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