Renal Handling of Urate in the Syndrome of Inappropriate Secretion of Antidiuretic Hormone

Acute renal failure due to uric acid nephropathy in a patient with renal hypouricemia

“…The mechanisms responsible for the development of severe hypouricemia have not been definitively clarified. Several investigators have suggested a four-component model for the renal handling of uric acid [1][2][3][4][5][6][7][11][12][13][14][15][16][17][18][19][20][21]. According to this model, urinary excretion of uric acid is determined by a) glomerular filtration, b) proximal or presecretory reabsorption, c) tubular secretion and d) postsecretory reabsorption.…”

“…An increase in uric acid excretion induced by probenecid is taken as a minimum estimate of the amount of uric acid reabsorbed postsecretorily. Pyrazinamide in pharmacological dosages seems to inhibit selectively the tubular secretion of uric acid [1,2,4,7,11,[14][15][16][17][18]. It almost eliminates urinary excretion in normal subjects.…”

“…Subsequently, twenty-three additional cases with this disorder were described [3,11,13,[15][16][17]. The basic clinical abnormalities accompanying the hypouricemia in these cases were: diabetes mellitus [14,17], XXYYsyndrome [11], inadequate secretion of antidiuretic hormone [15], renal calculi [13] and a case with associated hypercalciuria and decreased bone density [19].…”

Μελέτη Των Μηχανισμών Της Υπερουριχαιμίας Στην Ιδιοπαθή Υπέρταση

“…Έχει ήδη αναφερθεί η ουρικοζουρία και η υποουριχαιµία που παρατηρείται στο σύνδροµο της απρόσφορης υπερέκκρισης ADH (SIADH) και η οποία οφείλεται στη µεταβολή του εξωκυττάριου όγκου (Mees ED et al 1971, Decaux C et al 1980. Υποστηρίχθηκε ότι ο υπεύθυνος µηχανισµός είναι η αύξηση της σωληναριακής έκκρισης του ουρικού (Shichiri M et al 1985).…”