The renal handling of urate in acute renal failure patients with high urine uric acid/urine creatinine concentration ratio
Tungsanga, K.; Kateruttanakul, P.; Sitprija, V.
Journal of the Medical Association of Thailand 71(1): 29-32
1988
ISSN/ISBN: 0125-2208 PMID: 3361253 Document Number: 305623
The high uric acid/urine creatinine ratio (UUA/UC) is associated with acute renal failure (ARF) was recently reported (Tungsanga K, et al. Arch Intern Med 1984; 144: 934-7). To characterize the renal handling of urate (RHU) in such cases, we describe herein a preliminary study in 2 normal volunteers (N) aged 30 and 34 yr, and during the recovery period of ARF associated with high UUA/UC in 2 patients (P ) aged 24 and 45 yr, serum creatinine (Sc) = 1 and 0.98 mg/dl. The Sc and UUA/UC at maximum severity in P were 2.6 and 7.1 mg/dal and 1.9 and 1.4 respectively. Clearance study with oral 3 g pyrazinamide and 2 g probenecid was carried out separately on 2 consecutive days in each subject. Calculation was made for the presecretory tubular urate reabsortion (site 1), tubular secretion (site 2) and post-secretory reabsorption (site 3). The average values (A) for site 1,2 and 3 were 3.580 (N = 5,481), 1.839 (N = 1,560) and 843 at 100 ml GF were 86 (N = 98), 30 (N = 35) and 13 (N = 32) for site, 2 and 3 respectively. Our data seems to suggest an abnormal RHU in ARF associated with high UUA/UC. Both 1 and 3 were probably more affected than site 2. The validity of these results and whether they were due to ARF itself, hyperbilirubinemia or other factors needs further investigation.