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Modified forearm ischemic test in hypouricemic patients
I. Sebesta, D. Miyamoto, B. Stiburkova, S. Blahova, N. Sato, K. Nagata, K. Okamoto, S. Tsuruoka, K. Ichida
Language English Country United States
Document type Journal Article
- MeSH
- Adult MeSH
- Hypoxanthine blood MeSH
- Ischemia complications physiopathology MeSH
- Lactic Acid blood MeSH
- Uric Acid blood MeSH
- Middle Aged MeSH
- Humans MeSH
- Urinary Calculi complications MeSH
- Forearm blood supply physiopathology MeSH
- Renal Tubular Transport, Inborn Errors complications MeSH
- Exercise Test * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Renal hypouricemia sometimes leads to exercise-induced acute kidney injury (EIAKI) of unknown pathogenesis. In order to elucidate the various pathological conditions associated with hypouricemia, we analyzed the effects of low uric acid level on energy metabolism. We have modified semi-ischemic forearm exercise test and performed this test in one Japanese healthy volunteer, three patients with hereditary renal hypouricemia and one patient with hereditary xanthinuria of Czech origin. Forearm exercise was performed by squeezing a hand dynamometer with the sphygmomanometer cuff pressure kept at the mean arterial pressure. Venous blood was drawn five times (before exercise, 3, 10, 30, 45 minutes after the start of exercise) in each tests. The mean plasma lactate concentration increased from a baseline of 1.3 (range 0.7-1.8 mmol/L) to 4.0 (range 2.0-5.5 mmol/L) at 3 minutes after the start of exercise. The plasma hypoxanthine concentrations were quite low before exercise (0-2.9 μmol/L), but increased markedly to a range of 13.6-28.8 μmol/L after 10 minute forearm ischemia. Our protocol allowed us to conclude that the load was sufficient for observing metabolic changes in temporally hypoxia and in following recovery phase. The test was well tolerated and safe, we did not observe any adverse reactions including EIAKI.
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- $a Sebesta, Ivan $u Department of Pediatrics and Adolescent Medicine, Institute of Medical Biochemistry and Laboratory Diagnostics, Charles University First Faculty of Medicine, Prague, Czech Republic
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- $a Renal hypouricemia sometimes leads to exercise-induced acute kidney injury (EIAKI) of unknown pathogenesis. In order to elucidate the various pathological conditions associated with hypouricemia, we analyzed the effects of low uric acid level on energy metabolism. We have modified semi-ischemic forearm exercise test and performed this test in one Japanese healthy volunteer, three patients with hereditary renal hypouricemia and one patient with hereditary xanthinuria of Czech origin. Forearm exercise was performed by squeezing a hand dynamometer with the sphygmomanometer cuff pressure kept at the mean arterial pressure. Venous blood was drawn five times (before exercise, 3, 10, 30, 45 minutes after the start of exercise) in each tests. The mean plasma lactate concentration increased from a baseline of 1.3 (range 0.7-1.8 mmol/L) to 4.0 (range 2.0-5.5 mmol/L) at 3 minutes after the start of exercise. The plasma hypoxanthine concentrations were quite low before exercise (0-2.9 μmol/L), but increased markedly to a range of 13.6-28.8 μmol/L after 10 minute forearm ischemia. Our protocol allowed us to conclude that the load was sufficient for observing metabolic changes in temporally hypoxia and in following recovery phase. The test was well tolerated and safe, we did not observe any adverse reactions including EIAKI.
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- $a Miyamoto, Daisuke $u Department of Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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- $a Ichida, Kimiyoshi $u Division of Kidney and Hypertension, Department of Pathophysiology, Jikei University School of Medicine, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
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