Urate Nephropathy: A Rare Case Report

Abstract

Acute hyperuricemia most commonly occurs in patients who experience tumor-lysis syndrome. Hyperuricemia
along with other electrolyte abnormalities like hyperkalemia, hypocalcemia, and hyperphosphatemia leads to acute
kidney injury (AKI) due to acute uric acid nephropathy which is associated with significant morbidity. High risk
patients are thus closely monitored for signs of these laboratory abnormalities. Extreme exercise, rhabdomyolysis,
and seizures are rare causes of acute hyperuricemia. Serum uric acid level is not routinely monitored as a part
of postictal labs. We report an unusual case of AKI in a young male and no associated rhabdomyolysis who was
found to have acute uric acid nephropathy. Timely administration of Rasburicase prevented the need for dialysis
in this patient and led to complete renal recovery. This case illustrates the importance of doing a urine microscopy
and checking uric acid level in patients who develop unexplainable AKI, as timely management helps improve
outcome.