An 11-Year-Old Boy with Burkitt Lymphoma Is Brought to the Emergency

An 11-year-old boy with Burkitt lymphoma is brought to the emergency department because of nausea, vomiting, flank pain, and dark urine for 1 day. Two days ago, he began induction chemotherapy with cyclophosphamide, vincristine, prednisolone, and doxorubicin. His serum creatinine level is 2.7 mg/dL.  Renal biopsy reveals multiple uric acid crystals obstructing renal tubular lumen.  The principal site of uric acid precipitation would be which of the following?

A) Proximal tubules due to high solute concentration
B) Proximal tubules due to impaired uric acid transport
C) Loop of Henle due to urine hyposmolarity
D) Distal tubules due to high urine flow rate
E) Collecting ducts due to low urine pH

Correct Answer:

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