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Nephropathy, Urate

Esther Bak, M.D. Reviewed 04/2024
 


BASICS

  • Uric acid requires the enzyme uricase to convert it to a more soluble compound (allantoin); in humans, the enzyme is inactive, making the kidney more susceptible to the side effects of uric aci...

DIAGNOSIS

  • Hyperuricemic acute renal failure

    • Hyperkalemia: weakness, paresthesias, muscle cramps, nausea, vomiting, diarrhea, anorexia

    • Hyperphosphatemia: acute nephrocalcinosis

    • Hypocalcemia: muscle cramps...

TREATMENT

MEDICATION

  • Hyperuricemic acute renal failure: Prevent by pretreating with allopurinol or rasburicase and hydrating patient prior to administration of chemotherapeutic agents for leukemia or l...

ONGOING CARE

DIET

  • Moderation of purine intake (high purine foods include: mussels, codfish, anchovies, sardines, scallops, trout, codfish, haddock, bacon, turkey, venison, organ meats).

  • For nephrolithi...

REFERENCES

1
Mende  C. Management of chronic kidney disease: the relationship between serum uric acid and development of nephropathy. Adv Ther.  2015;...

CODES

ICD10

  • N28.89 Other specified disorders of kidney and ureter

  • N20.0 Calculus of kidney

  • M10.30 Gout due to renal impairment, unspecified site

SNOMED

  • 236495001 Urate nephropathy (disorder)

  • 236496000 acute...

CLINICAL PEARLS

  • Uric acid is water-insoluble in the acidic environment of the distal nephron of the kidney.

  • Due to the lack of the enzyme uricase, which converts uric acid into a more soluble compound,...

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