Uric acid clearances in man have been determined by several investigators. The values reported have ranged from 6.9 to 31.9 cc. per minute. This highest value was recently reported by one group from this laboratory (1). Subsequent attempts by us to confirm this figure have been unsuccessful. The values now obtained for uric acid clearances average about 15 cc. per minute or about one-half the value previously reported.Many possible explanations for this discrepancy presented themselves. First, a different method is now being use.d for the determination of uric acid. However, the methods have been carefully checked. They give nearly identical results. And second, the uric acid clearances performed previously in this laboratory were determined upon specimens of urine and blood, obtained from patients who were also receiving inulin and diodrast, while in the later studies, inulin and diodrast were absent. The presence of either one of these substances might, therefore, alter the normal excretion of uric acid and/or affect the determination of uric acid.It was readily determined that inulin and diodrast do not interfere with the determination of uric acid by the methods used in these experiments when these substances are added directly to the urine in quantities such that the final concentration is of the same order of magnitude as that found in the urine in clearance studies.It would also appear that the presence of inulin in the subject does not affect the uric acid clearance since Coombs et al. (2) we determined the effect of urine flow upon the uric acid clearance using our methods, since it is easier to obtain satisfactory urine collections for clearance determinations in the postpartum female if the urine flow is high. These experiments also assured us that we could measure the uric acid satisfactorily in very dilute urines. We then studied the effect of the injection of large quantities of glucose upon the uric acid clearance in order to determine if the reabsorption of supranormal amounts of glucose by the kidney tubule has any effect upon the uric acid clearance. We finally studied the effect of diodrast upon the uric acid clearance. Preliminary studies showed that diodrast did affect the excretion of uric acid. This effect was therefore studied in a separate series of cases.
SUBJECTS AND METHODSClinically normal women in their 1st to 8th postpartum day were used as experimental subjects. In the series of patients used to study the effect of water diuresis and glucose upon the uric acid clearance, sufficient water was given to insure an adequate flow. However, we also attempted to get a distribution of flows. In this series, the first clearance period was started about 9 a.m. In most cases (i.e. when the flow was high), the patients were not catheterized. Each clearance period averaged about 45 minutes. There were either 2 or 3 consecutive periods on the same day for each patient. Blood was drawn, either in the middle of the 2nd if there were 3 periods, or at the end of the 1st if there were 2 periods.In t...
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