Renal Excretion of Urate in Patients With Gout

Abstract

In recent years it has been shown that patients with gout usually excrete less urinary urate than do nongouty subjects whose plasma urate concentration has been elevated to the levels of patients with gout by acute loading with urate or its precursors.^1-3 These observations have led some investigators to conclude that impaired renal urate excretion is a frequent cause contributing to hyperuricemia in patients with gout. More recently Yü, Berger, and Gutman ⁴ have reported experiments which confirmed these observations but challenged the interpretation placed upon them. They suggested that the difference observed in renal excretion between the gouty and nongouty groups was the result of the acute urate loading of the nongouty subjects rather than the result of a difference in renal urate excretion between the two groups. In support of this suggestion they interpreted their data on urate loading as showing that "gouty subjects can excrete large