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Conference Proceedings

Modified forearm ischemic test in hypouricemic patients

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Pages 1432-1439 | Received 20 Dec 2019, Accepted 30 Mar 2020, Published online: 20 Apr 2020
 

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.

Additional information

Funding

Supported by the Institutional Support (Progres Q26-6) program of the Charles University, Prague; Czech Ministry of Health projects for conceptual development of research organization 00023728 (Institute of Rheumatology) and MH CZ DRO VFN 64165. Prof. Ichida and Dr. Okamoto have received grants from Teijin Pharma Co, Ltd.

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