WordNet

of critical importance and consequence; "an acute (or critical) lack of research funds"
having or demonstrating ability to recognize or draw fine distinctions; "an acute observer of politics and politicians"; "incisive comments"; "icy knifelike reasoning"; "as sharp and incisive as the stroke of a fang"; "penetrating insight"; "frequent penetrative observations" (同)discriminating, incisive, keen, knifelike, penetrating, penetrative, piercing, sharp
extremely sharp or intense; "acute pain"; "felt acute annoyance"; "intense itching and burning" (同)intense
having or experiencing a rapid onset and short but severe course; "acute appendicitis"; "the acute phase of the illness"; "acute patients"
of an angle; less than 90 degrees
street name for lysergic acid diethylamide (同)back breaker, battery-acid, dose, dot, Elvis, loony toons, Lucy in the sky with diamonds, pane, superman, window pane, Zen
any of various water-soluble compounds having a sour taste and capable of turning litmus red and reacting with a base to form a salt
having the characteristics of an acid; "an acid reaction"
in or relating to or obtained from urine; "uric acid"

PrepTutorEJDIC

(先の)『鋭い』,とがった / (痛み・感情などが)『激しい』,強い / (知力・感覚などが)『鋭い』,鋭敏な / (事態が)重大な / (病気が)急性の / (音が)高い,鋭い / 鋭角の
酸性の / 酸味のある,すっぱい(sour) / (言葉・態度などが)厳しい,しんらつな / 酸 / すっぱいもの / 《俗》=LSD
尿の,尿に関する(含まれている),尿から得られる

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/11/26 04:27:08」(JST)

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Acute uric acid nephropathy (AUAN, also acute urate nephropathy) is a rapidly worsening (decreasing) kidney function (renal insufficiency) that is caused by high levels of uric acid in the urine (hyperuricosuria).

Causes

Acute uric acid nephropathy is usually seen as part of the acute tumour lysis syndrome in patients undergoing chemotherapy or radiation therapy for the treatment of malignancies with rapid cell turnover, such as leukemia and lymphoma. It may also occur in these patients before treatment is begun, due to spontaneous tumor cell lysis (high incidence in Burkitt's lymphoma).

Acute uric acid nephropathy can also be caused by an acute attack of gout.

Pathophysiology

Acute uric acid nephropathy is caused by deposition of uric acid crystals within the kidney interstitium and tubules, leading to partial or complete obstruction of collecting ducts, renal pelvis, or ureter. This obstruction is usually bilateral, and patients follow the clinical course of acute renal failure.

Diagnosis

The picture of acute renal failure is observed: decreased urine production and rapidly rising serum creatinine levels. Acute uric acid nephropathy is differentiated from other forms of acute renal failure by the finding of a urine uric acid/creatinine ratio > 1 in a random urine sample.

Prevention

Patients at risk for acute uric acid nephropathy can be given allopurinol or rasburicase (a recombinant urate oxidase) prior to treatment with cytotoxic drugs.

Treatment

Treatment is focused on preventing deposition of uric acid within the urinary system by increasing urine volume with potent diuretics such as furosemide. Raising the urinary pH to a level higher than 7 (alkalinization) is often difficult to attain, although sodium bicarbonate and/or acetazolamide are sometimes used in an attempt to increase uric acid solubility.

Dialysis (preferably hemodialysis) is started if the above measures fail.

References

Conger JD (1990). "Acute uric acid nephropathy". Med Clin North Am. 74 (4): 859–71. PMID 2195258.
Robinson RR, Yarger WE (1977). "Acute uric acid nephropathy". Arch Intern Med. 137 (7): 839–40. doi:10.1001/archinte.137.7.839. PMID 879920.
Yu AS, Brenner BM (2005). "Chapter 266: Tubulointerstitial diseases of the kidney". In Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL. Harrison's Principles of Internal Medicine (16th ed.). New York: McGraw-Hill Professional. ISBN 978-0-07-140235-4

UpToDate Contents

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1. 尿酸による腎疾患 uric acid renal diseases
2. 腫瘍崩壊症候群：定義、発病メカニズム、臨床症状、原因および危険因子 tumor lysis syndrome definition pathogenesis clinical manifestations etiology and risk factors
3. 無症候性高尿酸血症 asymptomatic hyperuricemia
4. 腫瘍崩壊症候群：予防および治療 tumor lysis syndrome prevention and treatment
5. 非ホジキンリンパ腫の臨床症状および診断 clinical presentation and diagnosis of non hodgkin lymphoma

English Journal

Renal "hyperfiltrators" are at elevated risk of death and chronic diseases.

Altay S1, Onat A, Ozpamuk-Karadeniz F, Karadeniz Y, Kemaloğlu-Öz T, Can G.
BMC nephrology.BMC Nephrol.2014 Oct 2;15(1):160. doi: 10.1186/1471-2369-15-160.
BACKGROUND: The definition of glomerular hyperfiltration has not been agreed upon and the pathophysiological mechanisms have not been well explored. Low serum creatinine concentrations may be associated with increased risk of coronary heart disease (CHD) or cardiopulmonary events the impact of which
PMID 25278185

Prevention of comorbidity and acute attack of gout by uric acid lowering therapy.

Joo K, Kwon SR, Lim MJ, Jung KH, Joo H, Park W.
Journal of Korean medical science.J Korean Med Sci.2014 May;29(5):657-61. doi: 10.3346/jkms.2014.29.5.657. Epub 2014 Apr 25.
The object of this study was to evaluate the effect of uric acid lowering therapy in reducing the new development of comorbidities and the frequency of acute attacks in gout patients. We retrospectively reviewed patients who were diagnosed to have gout with at least 3 yr of follow up. They were divi
PMID 24851021

Contribution of platelets indices in the development of contrast-induced nephropathy.

Sahin I1, Karabulut A, Avci II, Okuyan E, Biter HI, Yildiz SS, Can MM, Gungor B, Dinckal M, Serebruany V.
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.Blood Coagul Fibrinolysis.2014 Apr 2. [Epub ahead of print]
Contrast-induced nephropathy (CIN) accounts for 10% of hospital-acquired renal failure, causes a prolonged in-hospital stay and represents a powerful predictor of poor clinical outcome. The underlying mechanism of the CIN development remains unclear and seems to be multifactorial. The potential link
PMID 24695089