Hyperuricemia, a Concomitant of Congenital Vasopressin-Resistant Diabetes Insipidus in the Adult

Abstract

Hyperuricemia was found in four adults but was absent in two children with congenital vasopressin-resistant diabetes insipidus. In the two oldest adults gouty arthritis developed at 30 and 42 years of age respectively. On a purine-free diet the 24-hour urinary excretion of urate was normal. Endogenous uric acid clearance was low in all adults, and the ratio of uric acid to creatinine clearance was low in three of four hyperuricemic patients. In the two patients studied, clearance of para-amino hippurate was low, and the filtration fraction elevated. All the adult patients had dilatation of the urinary collecting system. Plasma arginine vasopressin concentrations, measured by radioimmunoassay, were higher than normal for any given period of dehydration but appropriate for the osmolality. Neither water diuresis nor high concentrations of plasma vasopressin were found to affect the renal handling of urate.