Excess Urate Excretion Correlates with Severely Acidic Urine in Patients with Renal Hypouricemia.

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  • HISATOME Ichiro
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • TANAKA Yasushi
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • TSUBOI Mariko
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • YATSUHASHI Toru
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • OGINO Kazuhide
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • UCHIDA Toshihiko
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • YAMANOUCHI Yumi
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • SHIMOYAMA Masaki
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • FUJITA Shinya
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • KINUGAWA Toru
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • IGAWA Osamu
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • YOSHIDA Akio
    The First Department of Internal Medicine, Tottori University Faculty of Medicine
  • TAKEDA Akira
    The Third Department of Medicine, Matsue Red Cross Hospital
  • SATO Ryoichi
    The Department of Molecular Pharmacology and Biological Chemistry, Northwestern University Medical School
  • SHIGEMASA Chiaki
    The First Department of Internal Medicine, Tottori University Faculty of Medicine

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タイトル別名
  • Excess Urate Excretion Correlates with

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We evaluated the renal handling of urate in 12 Japanese renal hypouricemia patients, and studied the relationship between the renal handling of urate and the urinary pH. The patients were classified into the 4 subtypes of renal hypouricemia: (defective presecretory reabsorption (Pre), defective postsecretory reabsorption (Post), enhanced tubular secretion (Secretion), and defective presecretory and postsecretory reabsorption (Pre&Post) as based on a pharmacological test. Seven patients showed acid urine with a urinary pH of less than 5.9, although this was not accompanied by any abnormality of blood pH, partial pressure of carbon dioxide (PaCO2), or blood HCO3-. The urinary pH in the morning significantly correlated with the ratio of urate clearance to creatinine clearance in the morning, whereas the urinary urate concentration in the morning did not correlate with the urinary pH in the morning. In the Pre&Post patients, the urate excretion was higher and the urinary pH was more acidic compared to the other subtypes. The administration of K+-, Na+-citrate significantly alkalized the urinary pH in the patients with renal hypouricemia. These results suggest that the acidic urine was significantly related to the Pre&Post subtype of renal hypouricemia with the higher urate excretion, and that this subtype might be a risk factor for complications in renal hypouricemia. The alkalization of urine might be a useful treatment for the complication of renal hypouricemia.<br>(Internal Medicine 37: 726-731, 1998)

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  • Internal Medicine

    Internal Medicine 37 (9), 726-731, 1998

    一般社団法人 日本内科学会

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