临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (2): 99-.doi: 10.3969/j.issn.1000-3606.2021.02.005

• 泌尿系统疾病专栏 • 上一篇    下一篇

合并使用咪唑立宾及贝那普利诱发高尿酸血症伴急性肾损伤1例报告并文献复习

何旭,夏正坤   

  1. 中国人民解放军东部战区总医院(江苏南京 210002)
  • 发布日期:2021-02-07

Mizoribine and benazapril-associated hyperuricemia and acute kidney injury: a case report with review of the literature

HE Xu, XIA Zhengkun   

  1. The East Region General Hospitlal of The People’s Liberation Army, Nanjing 210002, Jiangsu, China
  • Published:2021-02-07

摘要: 目的 探讨咪唑立宾(MZR)诱发高尿酸血症及急性肾损伤(AKI)的临床特点及发病机制。方法 回顾分 析1例合并使用MZR及贝那普利诱发高尿酸血症伴AKI的IgA肾病患儿的临床资料。结果 男性患儿,13岁,确诊IgA 肾病5个月,基础肾功能无异常,合并使用MZR和贝那普利后出现一过性高尿酸血症和AKI,尿酸清除率明显降低至 3 . 66 mL/(min · 1 . 73 m2 ),尿钠排泄分数

关键词: : 咪唑立宾; 血管紧张素转化酶抑制剂; 高尿酸血症; 急性肾损伤

Abstract: Objective? To investigate the clinical characteristics and pathogenesis of hyperuricemia and acute kidney injury (AKI) induced by mizoribine (MZR). Methods? The clinical data of a case of IgA nephropathy with hyperuricemia induced by oral administration of MZR was retrospectively reviewed. Results? A 13 -year-old boy with IgA nephropathy was diagnosed for 5 months. The basic renal function was normal. Transient hyperuricemia and acute renal injury were found after combined use of benazepril and MZR. The uric acid clearance rate (UACl) was significantly reduced to 3.66 mL·min-1 ·1.73 m-2 , the fractional excretion of sodium (FENa) was less than one ( 0. 4%), and the fractional excretion of uric acid (FEUA) was increased to 17 . 1%, highly suggestive of pre-renal AKI. After stopping the above drugs, he received hydration treatment, then the renal function recovered rapidly. Conclusion? Hyperuricemia induced by MZR can not only cause post-renal AKI, but also reduce renal perfusion. When combined with angiotensin converting enzyme inhibitor, the effect of MZR on uric acid metabolism and the adverse reactions should be found in time for further adjustment of the medication.

Key words: ? mizoribine;? angiotensin converting enzyme inhibitor;? hyperuricemia;? acute kidney injury