TY - JOUR
T1 - Anuria secondary to hot weather-induced hyperuricaemia
T2 - Diagnosis and management
AU - Al-Tawheed, Adel R.
AU - Al-Awadi, Khaleel A.
AU - Kehinde, Elijah O.
AU - Abdul-Halim, Hamdy
AU - Al-Hunayan, Adel
AU - Ali, Yousef
AU - Mohammed, Akram H.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2003
Y1 - 2003
N2 - Background: There is little information on the management of anuria secondary to severe volume depletion or as a rare manifestation of heat stroke in areas of the world with very hot summers. We present our experience with hot weather-induced hyperuricaemia in Kuwait. Patients and Methods: Patients presenting to our urology unit as an emergency during the hot summer months of April to October (average temperature 40-55°C) were suspected of having hot weather-induced anuria secondary to hyperuricemia if they had a history of working in the sun for 6 to 8 hours per day and a progressive decrease in urine output to complete anuria. The diagnosis was confirmed by demonstration of elevated serum creatinine and uric acid, ultrasound findings of normal kidneys, ureters, and bladder (KUB) or mild to moderate hydronephrosis, but no features of chronic renal disease and little or no urine in the bladder. Management consisted of emergency cystoscopy, retrograde pyelogram, ureterorenoscopy (URS), and 'J' stents followed by rehydration, oral allopurinol and urinary alkalinization. Results: Twenty-nine patients (27 males and 2 females, mean age, 44.52±8.3 years) satisfied the diagnostic criteria for anuria secondary to hot weather-induced hyperuricaemia. Twenty-eight (97%) patients worked outdoors on construction sites. Six patients had small radiopaque calculi on plain KUB X-ray. During cytoscopy and URS, uric acid crystals were encountered in all patients in the ureters and bladder. Recovery of renal function was complete in 23/29 (79.3%) patients, while 4/29 (13.8%) had partial recovery and 2/29 (6.9%) had no renal recovery. Conclusion: Hot weather-induced anuria secondary to hyperuricaemia is a complication of severe dehydration. Effective treatment will result in successful resolution of this rare but reversible cause of acute renal failure in about 80% of cases. Ancillary treatment methods like haemodialysis or the use of PCN can be safely avoided in the majority of the patients. However, rehydration alone may be insufficient treatment in these patients.
AB - Background: There is little information on the management of anuria secondary to severe volume depletion or as a rare manifestation of heat stroke in areas of the world with very hot summers. We present our experience with hot weather-induced hyperuricaemia in Kuwait. Patients and Methods: Patients presenting to our urology unit as an emergency during the hot summer months of April to October (average temperature 40-55°C) were suspected of having hot weather-induced anuria secondary to hyperuricemia if they had a history of working in the sun for 6 to 8 hours per day and a progressive decrease in urine output to complete anuria. The diagnosis was confirmed by demonstration of elevated serum creatinine and uric acid, ultrasound findings of normal kidneys, ureters, and bladder (KUB) or mild to moderate hydronephrosis, but no features of chronic renal disease and little or no urine in the bladder. Management consisted of emergency cystoscopy, retrograde pyelogram, ureterorenoscopy (URS), and 'J' stents followed by rehydration, oral allopurinol and urinary alkalinization. Results: Twenty-nine patients (27 males and 2 females, mean age, 44.52±8.3 years) satisfied the diagnostic criteria for anuria secondary to hot weather-induced hyperuricaemia. Twenty-eight (97%) patients worked outdoors on construction sites. Six patients had small radiopaque calculi on plain KUB X-ray. During cytoscopy and URS, uric acid crystals were encountered in all patients in the ureters and bladder. Recovery of renal function was complete in 23/29 (79.3%) patients, while 4/29 (13.8%) had partial recovery and 2/29 (6.9%) had no renal recovery. Conclusion: Hot weather-induced anuria secondary to hyperuricaemia is a complication of severe dehydration. Effective treatment will result in successful resolution of this rare but reversible cause of acute renal failure in about 80% of cases. Ancillary treatment methods like haemodialysis or the use of PCN can be safely avoided in the majority of the patients. However, rehydration alone may be insufficient treatment in these patients.
KW - 'J' stents
KW - Anuria
KW - Hot weather
KW - Hyperuricaemia
KW - Uric acid nephropathy
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U2 - 10.5144/0256-4947.2003.283
DO - 10.5144/0256-4947.2003.283
M3 - Article
C2 - 16868395
AN - SCOPUS:0141960257
VL - 23
SP - 283
EP - 287
JO - Annals of Saudi Medicine
JF - Annals of Saudi Medicine
SN - 0256-4947
IS - 5
ER -