Abstract 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.

中文翻译：

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低尿酸血症患者改良前臂缺血试验

摘要 肾性低尿酸血症有时会导致发病机制不明的运动性急性肾损伤（EIAKI）。为了阐明与低尿酸血症相关的各种病理状况，我们分析了低尿酸水平对能量代谢的影响。我们改进了半缺血前臂运动试验，并在一名日本健康志愿者、三名遗传性肾性低尿酸血症患者和一名捷克血统的遗传性黄嘌呤尿症患者中进行了这项测试。前臂锻炼是通过挤压手测力计来进行的，血压计袖带压力保持在平均动脉压。在每次测试中，静脉采血五次（运动前，运动开始后 3、10、30、45 分钟）。平均血浆乳酸浓度从基线的 1.3（范围 0.7-1.8 mmol/L）增加到 4。运动开始后 3 分钟时为 0（范围 2.0-5.5 mmol/L）。运动前血浆次黄嘌呤浓度相当低（0-2.9 μmol/L），但在前臂缺血 10 分钟后显着升高至 13.6-28.8 μmol/L。我们的协议使我们能够得出结论，负载足以观察暂时缺氧和随后恢复阶段的代谢变化。该测试具有良好的耐受性和安全性，我们没有观察到任何不良反应，包括 EIAKI。我们的协议使我们能够得出结论，负载足以观察暂时缺氧和随后恢复阶段的代谢变化。该测试具有良好的耐受性和安全性，我们没有观察到任何不良反应，包括 EIAKI。我们的协议使我们能够得出结论，负载足以观察暂时缺氧和随后恢复阶段的代谢变化。该测试具有良好的耐受性和安全性，我们没有观察到任何不良反应，包括 EIAKI。