Renal clearance of uric acid is linked to insulin resistance and lower excretion of sodium in gout patients

Rheumatology International
Fernando Perez-RuizToni Merriman

Abstract

Inefficient renal excretion of uric acid is the main pathophysiological mechanism for hyperuricemia in gout patients. Polymorphisms of renal tubular transporters linked with sodium and monosaccharide transport have yet to be demonstrated. We intended to evaluate the impact of insulin resistance, evaluated with the homeostasis model assessment (HOMA), through a transversal study of non-diabetic patients with gout, with normal renal function, not treated with any medication but colchicine as prophylaxis. One hundred and thirty-three patients were evaluated. Clearance of uric acid was inversely correlated with insulin resistance and directly correlated with fractional excretion of sodium. In multivariate analysis, hypertension and hyperlipidemia, in addition to insulin resistance and fractional excretion of sodium, were associated with renal clearance of uric acid. HOMA cutoff for efficient versus inefficient renal handling of uric acid was 2.72, close to that observed in studies of reference population. The impact of insulin resistance and renal handling of sodium on renal clearance of uric acid may help to explain why hyperuricemia is more commonly associated with diabetes and hypertension.

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Citations

Sep 29, 2015·Current Medical Research and Opinion·F Perez-Ruiz, M A Becker
Dec 13, 2016·Expert Review of Clinical Pharmacology·Robert Terkeltaub
Mar 3, 2018·Current Diabetes Reports·Ambreen Gul, Philip Zager
Oct 21, 2017·Therapeutic Advances in Endocrinology and Metabolism·Cesar I Elizalde-BarreraAlberto F Rubio-Guerra
Mar 6, 2018·Diabetes/metabolism Research and Reviews·Minchao LiQinglin Lou
Jan 26, 2016·Current Opinion in Rheumatology·Fernando Perez-RuizLoreto Carmona-Ortells
Mar 4, 2020·International Journal of Molecular Medicine·Xiaoru XiaLi Sun
Jul 27, 2018·Evidence-based Complementary and Alternative Medicine : ECAM·Yansheng WuJiandong Gao
May 26, 2018·Rheumatology·Sheng-Wen NiuHugo You-Hsien Lin
Mar 15, 2019·Internal and Emergency Medicine·Giovambattista DesideriCelestino Pio Lombardi
Nov 10, 2018·Evidence-based Complementary and Alternative Medicine : ECAM·Peng WuWeifeng Sun
Sep 12, 2019·Current Diabetes Reports·Alan SacerdoteGül Bahtiyar
Jan 3, 2021·International Urology and Nephrology·Fengqin LiZhibin Ye
Aug 20, 2021·Frontiers in Physiology·Asim K MandalDavid B Mount

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