Premium
THE RENAL EXCRETION OF URATE IN CHRONIC LEAD NEPHROPATHY
Author(s) -
EMMERSON B. T.
Publication year - 1965
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1965.14.4.295
Subject(s) - uric acid , nephritic syndrome , medicine , creatinine , endocrinology , renal function , gout , nephropathy , excretion , chemistry , kidney , glomerulonephritis , diabetes mellitus
SUMMARY Patients with chronic lead nephropathy frequently develop gout. A group of lead‐nephritic patients was therefore compared with a group of patients with chronic renal disease due to causes other than lead or primary gout in regard to the following features: (i) the plasma concentrations of urate and phosphate in relation to the creatinine clearance; (ii) the renal clearances of urate, creatinine, urea and phosphate; (iii) the effect on the urate clearance of elevation of the plasma urate concentration by a purine load; (iv) the effect on the urate clearance of partial blockade of tubular reabsorption of urate by a uricosuric drug. When allowance was made for the differences in creatinine clearances between the groups, the findings were as follows. (i) The plasma‐urate concentrations were significantly higher in the lead‐nephritic group and did not tend to increase with increasing renal failure, whereas the plasma‐phosphate concentrations were not significantly different in the two groups and tended to increase with increasing renal failure. (ii) The lead‐nephritic group showed lower urate clearances and higher phosphate clearances than the non‐lead‐nephritic group, and the lead‐nephritic group alone showed significant regressions of the urate clearance on both the creatinine and urea clearances. (iii) With elevation of the plasma‐urate concentration by a purine load, there was a significant fall in the urate clearance in those lead‐nephritic patients who had a mean urate clearance of 3 ml. per minute or more. (iv) There was no significant difference between the increases in urate clearance after a uricosuric drug in the two groups. These findings were consistent with a defect in renal excretion of urate in chronic lead nephropathy most readily explicable by defective tubular secretion of urate.