Allopurinol in the treatment of uraemic patients with gout.

Abstract

Allopurinol was given for up to 11 months to 12 uremic patients with severe gout. A dramatic clinical improvement occurred with a decreased frequency and severity of acute gout in all but 1 patient. Serum uric acid levels are at present below 6.5 mg/100 ml in the 10 patients alive, who have a mean serum urea of 102 mg/100 ml. Daily urinary uric acid excretion has fallen by 37%. Using a new method for estimating oxypurines which employs xanthine oxidase followed by uricase, the mean urinary 24-hr. oxypurine excretion has risen from 3.5 to 72 mg/day. Daily "total" urinary purines (being the sum of uric acid, hypoxanthine, and xanthine) have fallen only slightly with treatment and there is an overlap in daily levels of excretion before and during allopurinol therapy. Two patients died of renal failure, but a significant improvement in renal function occurred in two other patients. Transient diarrhea, rashes, and a persistent reticulocytosis were minor side-effects.