Renal Handling of Uric Acid in Patients with Recurrent Calcium Nephrolithiasis and Hyperuricosuria
作者:
F. Mateos Antón,
J. García Puig,
G. Gaspar,
A. Muñoz Sanz,
E. Herrero,
T. Ramos,
M.E. Martínez,
J.M. Gómez Mantilla,
期刊:
Nephron
(Karger Available online 1984)
卷期:
Volume 37,
issue 2
页码: 123-127
ISSN:1660-8151
年代: 1984
DOI:10.1159/000183227
出版商: S. Karger AG
关键词: Probenecid;Nephrolithiasis;Hyperuricosuria;Pyrazinamide
数据来源: Karger
摘要:
Hyperuricosuria is a frequent finding in patients with recurrent calcium nephrolithiasis (RCN) that has been related to purine overingestion. The influence of diet and the renal handling of uric acid were investigated in patients with RCN to assess the pathogenic mechanism of excessive urate excretion. Among 50 patients with recurrent nephrolithiasis 42 formed renal stones containing calcium and 9 of these 42 patients demonstrated concomitant asymptomatic hyperuricosuria while on a self-selected diet. Ingestion of a purine-free diet normalized the uric acid excretion in 4 of these 9 patients. The other 5 patients showed persistent hyperuricosuria while on a purine-free diet. In order to assess a possible dysfunction in the renal handling of uric acid, pharmacological tests were undertaken in these 9 patients. Pyrazinamide administration almost completely suppressed urate excretion, excluding a presecretory reabsorption defect. Urate excretion in response to probenecid administration was decreased in 4 patients and increased in 1. This finding is in accordance with a postsecretory reabsorption defect in the former and an augmented tubular secretion of urate in the latter. This study proves that both dietary factors and tubular transport defects are involved in patients with recurrent calcium nephrolithiasis and hyperuricosuria.
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