nach oben

Erschienen in:

13.11.2017 | Original Article

Hyperammonemia associated with distal renal tubular acidosis or urinary tract infection: a systematic review

verfasst von: Caterina M. Clericetti, Gregorio P. Milani, Sebastiano A. G. Lava, Mario G. Bianchetti, Giacomo D. Simonetti, Olivier Giannini

Erschienen in: Pediatric Nephrology | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Hyperammonemia usually results from an inborn error of metabolism or from an advanced liver disease. Individual case reports suggest that both distal renal tubular acidosis and urinary tract infection may also result in hyperammonemia.

Methods

A systematic review of the literature on hyperammonemia secondary to distal renal tubular acidosis and urinary tract infection was conducted.

Results

We identified 39 reports on distal renal tubular acidosis or urinary tract infections in association with hyperammonemia published between 1980 and 2017. Hyperammonemia was detected in 13 children with distal renal tubular acidosis and in one adult patient with distal renal tubular acidosis secondary to primary hyperparathyroidism. In these patients a negative relationship was observed between circulating ammonia and bicarbonate levels (P < 0.05). In 31 patients (19 children, 12 adults), an acute urinary tract infection was complicated by acute hyperammonemia and symptoms and signs of acute neuronal dysfunction, such as an altered level of consciousness, convulsions and asterixis, often associated with signs of brain edema, such as anorexia and vomiting. Urea-splitting bacteria were isolated in 28 of the 31 cases. The urinary tract was anatomically or functionally abnormal in 30 of these patients.

Conclusions

This study reveals that both altered distal renal tubular acidification and urinary tract infection may be associated with relevant hyperammonemia in both children and adults.

“Ammonia” [2] can exist in two molecular forms, NH₃ (free ammonia) and NH₄ ⁺ (ammonium cation). Throughout this review, “ammonia” refers to the combination of both molecules; “NH₃” refers specifically to the molecular form of NH₃; “NH₄ ⁺” refers specifically to the molecular form NH₄ ⁺.

Häberle J (2013) Clinical and biochemical aspects of primary and secondary hyperammonemic disorders. Arch Biochem Biophys 536:101–110CrossRefPubMed

Weiner ID (2017) Roles of renal ammonia metabolism other than in acid–base homeostasis. Pediatr Nephrol 32:933–942

Clericetti CM, Milani GP, Bianchetti MG (2017) Una neonata di 3½ settimane con cattivo accrescimento ponderale di “origine doppia”. Trib Med Tic 82:143–144

Miller SG, Schwartz GJ (1997) Hyperammonaemia with distal renal tubular acidosis. Arch Dis Child 77:441–444CrossRefPubMedPubMedCentral

Seracini D, Poggi GM, Pela I (2005) Hyperammonaemia in a child with distal renal tubular acidosis. Pediatr Nephrol 20:1645–1647CrossRefPubMed

Pela I, Seracini D (2007) Hyperammonemia in distal renal tubular acidosis: is it more common than we think? Clin Nephrol 68:109–114CrossRefPubMed

Bonnie R, Hu R (2008) Hyperammonaemia due to primary hyperparathyroidism-related renal tubular acidosis with incidental hypovitaminosis-D. Eur J Intern Med 19:e94–e96CrossRefPubMed

Okan F, Bereket G, Nikain A, Guven G (2008) An unusual cause of hyperammonemia in a newborn: question. Pediatr Nephrol 23:553–557CrossRefPubMed

Saito T, Hayashi D, Shibata S, Jogamoto M, Kamoda T (2010) Novel compound heterozygous ATP6V0A4 mutations in an infant with distal renal tubular acidosis. Eur J Pediatr 169:1271–1273CrossRefPubMed

10.

Ripoli C, Pinna A, Marras S, Fenu ML, Nurchi AM (2012) A distal renal tubular acidosis showing hyperammonemia and hyperlactacidemia. Pediatr Med Chir 34:198–201CrossRefPubMed

11.

Saini A, Karmakar SA, Kannikeswaran N (2012) Concomitant hypercalcemia and hyperammonemia associated with distal renal tubular acidosis. Pediatr Emerg Care 28:280–282CrossRefPubMed

12.

Miura K, Sekine T, Takahashi K, Takita J, Harita Y, Ohki K, Park MJ, Hayashi Y, Tajima A, Ishihara M, Hisano M, Murai M, Igarashi T (2013) Mutational analyses of the ATP6V1B1 and ATP6V0A4 genes in patients with primary distal renal tubular acidosis. Nephrol Dial Transplant 28:2123–2130CrossRefPubMed

13.

Hsu KH, Cheng CH, Tseng MH, Hsu JF, Lien R, Yang PH (2015) Hyperammonemia in distal renal tubular acidosis: a new case and review of the literature. Pediatr Neonatol 56:432–434CrossRefPubMed

14.

Samtoy B, DeBeukelaer MM (1980) Ammonia encephalopathy secondary to urinary tract infection with Proteus mirabilis. Pediatrics 65:294–297PubMed

15.

Drayna CJ, Titcomb CP, Varma RR, Soergel KH (1981) Hyperammonemic encephalopathy caused by infection in a neurogenic bladder. N Engl J Med 304:766–768CrossRefPubMed

16.

Ullman MA, Haecker TA, Medani CR (1981) Hyperammonemic encephalopathy and urinary obstruction. N Engl J Med 304:1546PubMed

17.

Sinha B, Gonzalez R (1984) Hyperammonemia in a boy with obstructive ureterocele and proteus infection. J Urol 131:330–331CrossRefPubMed

18.

Kuntze JR, Weinberg AC, Ahlering TE (1985) Hyperammonemic coma due to Proteus infection. J Urol 134:972–973CrossRefPubMed

19.

Diamond DA, Blight A, Ransley PG (1989) Hyperammonemic encephalopathy: a complication associated with the prune belly syndrome. J Urol 142:361–362CrossRefPubMed

20.

Goldstein B, Brown MR, Hulbert WC Jr, Rabinowitz R (1991) Hyperammonemic encephalopathy secondary to diphtheroid urinary tract infection in a patient with prune belly syndrome. Crit Care Med 19:578–586CrossRefPubMed

21.

Arnold WC, Allen WR (1995) Clinical quiz. Hyperammonemic coma secondary to pyelonephritis. Pediatr Nephrol 9:667–668CrossRefPubMed

22.

Das A, Henderson D (1996) Hyperammonemic encephalopathy in a four-year-old child with prune belly syndrome. Pediatr Infect Dis J 15:922–926CrossRefPubMed

23.

Cheang HK, Rangecroft L, Plant ND, Morris AA (1998) Hyperammonaemia due to Klebsiella infection in a neuropathic bladder. Pediatr Nephrol 12:658–659CrossRefPubMed

24.

van Daele PL, Quero Guillen JC, Lesterhuis W, Van Der Meulen J (1998) Hyperammoniëmie bij hydronefrose. Ned Tijdschr Geneeskd 142:2414–2415PubMed

25.

Zuberi SM, Stephenson JB, Azmy AF, Robinson PH, McWilliam RC (1998) Hyperammonaemic encephalopathy after a subureteric injection for vesicoureteric reflux. Arch Dis Child 79:363–364CrossRefPubMedPubMedCentral

26.

Kiyokawa H, Igawa Y, Nishizawa O (2001) Hyperammonaemic encephalopathy associated with retention of urine in multiple large diverticula. BJU Int 88:122–123CrossRefPubMed

27.

McEwan P, Simpson D, Kirk JM, Barr DG, McKenzie KJ (2001) Short report: Hyperammonaemia in critically ill septic infants. Arch Dis Child 84:512–513CrossRefPubMedPubMedCentral

28.

Murray T, Comeau LL (2001) Hyperammonemic coma caused by Providencia rettgeri infection in a child with prune belly syndrome. Pediatr Crit Care Med 2:178–180CrossRefPubMed

29.

De Jonghe B, Janier V, Abderrahim N, Hillion D, Lacherade JC, Outin H (2002) Urinary tract infection and coma. Lancet 360:996CrossRefPubMed

30.

Laube GF, Superti-Furga A, Losa M, Büttiker V, Berger C, Neuhaus TJ (2002) Hyperammonaemic encephalopathy in a 13-year-old boy. Eur J Pediatr 161:163–164CrossRefPubMed

31.

Gabra HO, Fenton PA, Bonham JR, Mackinnon AE (2003) Hyperammonemia with complex urinary tract anomaly: a case report. J Pediatr Surg 38:E16–E17CrossRefPubMed

32.

Lokrantz CM, Eriksson B, Rosén I, Asztely F (2004) Hyperammonemic encephalopathy induced by a combination of valproate and pivmecillinam. Acta Neurol Scand 109:297–301CrossRefPubMed

33.

Albersen M, Joniau S, Van Poppel H, Cuyle PJ, Knockaert DC, Meersseman W (2007) Urea-splitting urinary tract infection contributing to hyperammonemic encephalopathy. Nat Clin Pract Urol 4:455–458CrossRefPubMed

34.

Fitzpatrick E, Mayne P, Gill D (2007) A confused child. Diagnosis: urinary tract infection, dilated urinary system and associated hyperammonaemic encephalopathy. Pediatr Nephrol 22:355–357CrossRefPubMed

35.

Volpato S, Cavalieri M, Mari E, Fellin R (2007) An unusual case of hyperammonemia in a 83-year-old woman. Aging Clin Exp Res 19:506–508CrossRefPubMed

36.

Sato S, Yokota C, Toyoda K, Naganuma M, Minematsu K (2008) Hyperammonemic encephalopathy caused by urinary tract infection with urinary retention. Eur J Intern Med 19:e78–e79CrossRefPubMed

37.

Kenzaka T, Kumabe A, Urushibara Y, Minami K (2013) Hyperammonemia in a patient with obstructive urinary tract infection due to Corynebacterium urealyticum. Cent Eur J Med 8:597–599

38.

Cordano C, Traverso E, Calabrò V, Borzone C, Stara S, Marchese R, Marinelli L (2014) Recurring hyperammonemic encephalopathy induced by bacteria usually not producing urease. BMC Res Notes 7:324CrossRefPubMedPubMedCentral

39.

Miyauchi R, Matsuda Y, Tokuda Y (2015) Urinary tract infection as a cause of hyperammonemic encephalopathy. Gen Med 16:95–98CrossRef

40.

Dawson LP, Lee SJ, Hollander YS (2016) Valproate-induced hyperammonemic encephalopathy associated with urinary tract infection and urinary retention in the psychiatric setting. Aust N Z J Psychiatry 50:1110CrossRefPubMed

41.

Kenzaka T, Kato K, Kitao A, Kosami K, Minami K, Yahata S, Fukui M, Okayama M (2015) Hyperammonemia in urinary tract infections. PLoS One 10:e0136220CrossRefPubMedPubMedCentral

42.

Besouw MTP, Bienias M, Walsh P, Kleta R, Van’t Hoff WG, Ashton E, Jenkins L, Bockenhauer D (2017) Clinical and molecular aspects of distal renal tubular acidosis in children. Pediatr Nephrol 32:987–996 (Erratum in: Pediatr Nephrol 32:1095)CrossRefPubMed

43.

Bertini A, Milani GP, Simonetti GD, Fossali EF, Faré PB, Bianchetti MG, Lava SAG (2016) Na⁺, K⁺, Cl⁻, acid-base or H₂O homeostasis in children with urinary tract infections: a narrative review. Pediatr Nephrol 31:1403–1409

44.

Milani GP, Grava A, Bianchetti MG, Lava SAG, Dell'Era L, Teatini T, Fossali EF (2017) Electrolyte and acid-base abnormalities in infants with community-acquired acute pyelonephritis: prospective cross-sectional study. Nephron 137:99–104CrossRefPubMed

45.

Reddy P (2011) Clinical approach to renal tubular acidosis in adult patients. Int J Clin Pract 65:350–360CrossRefPubMed

46.

Santos F, Ordóñez FA, Claramunt-Taberner D, Gil-Peña H (2015) Clinical and laboratory approaches in the diagnosis of renal tubular acidosis. Pediatr Nephrol 30:2099–2107CrossRefPubMed

47.

Baumer JH, Jones RW (2007) Urinary tract infection in children, National Institute for health and clinical excellence. Arch Dis Child Educ Pract Ed 92:189–192CrossRefPubMed

48.

Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB (2011) Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 128:595–610CrossRef

49.

Ammenti A, Cataldi L, Chimenz R, Fanos V, La Manna A, Marra G, Materassi M, Pecile P, Pennesi M, Pisanello L, Sica F, Toffolo A, Montini G, Italian Society of Pediatric Nephrology (2012) Febrile urinary tract infections in young children: recommendations for the diagnosis, treatment and follow-up. Acta Paediatr 101:451–457CrossRefPubMed

Titel: Hyperammonemia associated with distal renal tubular acidosis or urinary tract infection: a systematic review
verfasst von: Caterina M. Clericetti
Gregorio P. Milani
Sebastiano A. G. Lava
Mario G. Bianchetti
Giacomo D. Simonetti
Olivier Giannini
Publikationsdatum: 13.11.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 3/2018
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3829-7

Neu im Fachgebiet Pädiatrie

23.04.2024 | Typ-1-Diabetes | Nachrichten

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Hyperammonemia associated with distal renal tubular acidosis or urinary tract infection: a systematic review

Abstract

Background

Methods

Results

Conclusions

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2018

Role of renal sympathetic nerve activity in prenatal programming of hypertension

Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment

Diffuse mesangial sclerosis in a PDSS2 mutation-induced coenzyme Q10 deficiency

Complement functional tests for monitoring eculizumab treatment in patients with atypical hemolytic uremic syndrome: an update

Effects of growth hormone treatment on adult height in severely short children with X-linked hypophosphatemic rickets

Expanding the role of vasopressin antagonism in polycystic kidney diseases: From adults to children?

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie