Renal Hypouricemia with Both Drug-Insensitive Secretion and Defective Reabsorption of Urate: A Novel Type of Renal Hypouricemia

Abstract

Renal handling of urate in the hypouricemic patient with increase in both urate clearance (Cur) and Cur/creatinine clearance (Ccr) and normal urinary excretion of urate was studied according to the pharmacological evaluation. In the present case there was no response of urate excretion to either pyrazinamide or probenecid. Both furosemide and prednisolone could not alter Cur and Cur/ Ccr. Administration of inosine could have increased Cur, which was greater than Ccr. These results suggest that the present case had the defect of both pre- and postsecretory reabsorption of urate, accompanied by the existence of drug-insensitive secretion of urate, which is different from hitherto known types of renal hypouricemia, i.e. a novel type of renal hypouricemia.

Effects of Irbesartan on Uric Acid Metabolism in Patients with Treated Essential Hypertension

“…Blood and urinary tests to determine serum urate (Sur), urinary uric acid (Uur), Scr, and urinary creatinine (Ucr) were regularly carried out and analyzed at baseline and after 3 months of treatment. Urate clearance (Cur), creatinine clearance (Ccr), the ratio of urinary uric acid to urinary creatinine (Uur/Ucr), and the ratio of uric acid clearance to creatinine clearance (Cur/Ccr) were determined according to a previously described method 14,15) , before and after treatment with irbesartan. To assess changes in uric acid metabolism after treatment, we allocated patients into two groups, patients with Uur/Ucr <0.5 (low Uur/Ucr group, n= 20) or those with Uur/Ucr !…”

Exercise-induced acute renal failure in a patient with renal hypouricemia

“…He was maintained on an unrestricted diet during the studies. Pyrazinamide and probenecid tests were performed by previously reported methods [2]. The patient was hydrated orally with water in amounts sufficient to provide a steady rate of urine flow of at least 1 ml/min.…”