Uric acid excretion in the relatives of patients with gout.

Abstract

This paper describes a study in which uric acid excretion in patients with gout was compared with that of their close relatives. MethodsThe patients all had a diagnosis of primary gout, i.e. they had a characteristic history of acute episodic arthritis with a serum uric acid level above 6 mg./100 ml. and no evident underlying cause for hyperuricaemia. The investigation was carried out before treatment with uratelowering drugs was started. The nature of the study was explained to them and to as many as possible of their adult first-degree relatives, and all the participants were carefully instructed in the details of a low-purine alcoholfree diet (National Institute of Health, Bethesda low purine diet: daily purine content approximately 200 mg.) which they took for 6 days. On the last day they collected a 24-hour urine sample in a provided container which they delivered within a few hours of completion, when a blood sample was also taken. Uric acid and creatinine levels in these samples were estimated by Technicon Auto-Analyzer. 46 patients with 107 adult relatives participated in the investigation. Of these patients, 33 had male relatives and 31 had female relatives, and figures from all these subjects were taken in the analysis relating to serum uric acid levels. Some patients and relatives were excluded from studies involving urine collections, either because creatinine clearance was less than 60 ml./min. (indicating either renal impairment or incomplete urine collection) or, in one instance, because dietary restrictions had clearly been disregarded. The final analysis relating to uric acid excretion therefore applied to 37 patients (36 men and 1 woman) and 96 relatives, of whom 42 were brothers, 40 sisters, 5 mothers, 3 fathers, 3 daughters, and 3 sons; 27 of the gout patients had male relatives and 26 had female relatives. Two of the relatives themselves had gout, but had not taken any treatment for several months.

Fractional clearance of urate: validation of measurement in spot-urine samples in healthy subjects and gouty patients

“…The FCU has not been examined widely in studies on urate, although it has been used in heritability studies in twins [9] and correlations on the handling of urate in gouty patients and their relatives [34]. A significant association has been found between a low FCU (≤6.6%) and SLC2A9 variants [11], and thus highlights the potential of the FCU in understanding the function of SNPs in other urate transporters.…”

Diuretic induced gout: a multifactorial condition.

“…One further patient had been treated for hypothyroidism, a condition which has been associated with hyperuricaemia,6 though this is contentious.7 8 Two patients had a family history of gout; one had evidence of an impaired glomerular filtration rate, and the other had a normal renal function as seen by a normal concentration of urea in blood. Relatives of patients with gout have significantly higher values of serum urate than controls9 10 and it is possible that these two patients had been hyperuricaemic before the effect of the diuretics was added.…”

Effect of Oestrogen Therapy on Plasma and Urinary Levels of Uric Acid

“…Wolfson et al (1949) found that uric acid clearance was rather higher in healthy women than in men, averaging 12-67 ml/min in women and 10-38 ml/min in men. Scott and Pollard (1970), studying the healthy relatives of gouty patients, made sianilar observations. Mean uric acid clearance in male relatives was 7-7 ml/min and in female relatives 8-9 ml/min, and the ratio of uric acid to creatinine clearance was greater in women than in men.…”