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Hypoxanthine, xanthine, and uric acid concentrations in plasma, cerebrospinal fluid, vitreous humor, and urine in piglets subjected to intermittent versus continuous hypoxemia.

Infants with sudden infant death syndrome have higher hypoxanthine (Hx) concentrations in their vitreous humor than infants with respiratory distress syndrome and other infant control populations. However, previous research on piglets and pigs applying continuous hypoxemia has not been able to reproduce the concentrations observed in infants with sudden infant death syndrome. To test whether intermittent hypoxemia could, in part, explain this observed difference, Hx, xanthine (X), and uric acid were measured in vitreous humor, urine, plasma, and cerebrospinal fluid in newborn piglets during intermittent hypoxemia (IH) or continuous hypoxemia (CH) of equal degree and duration. Urinary Hx excretion was significantly higher (p < 0.04) in the IH group after 60 min of hypoxemia. The vitreous humor Hx increase was significantly higher in the IH group (from 21.0 +/- 7.8 to 44.1 +/- 25.5 mumol/L, p < 0.01 versus baseline) than in the CH group (from 16.4 +/- 4.2 to 23.2 +/- 7.3 mumol/L, p < 0.05 versus baseline) (p < 0.05 IH versus CH). X increased significantly more (p < 0.05) in vitreous humor in the IH group than in the CH group. No differences between the two groups were found in plasma and cerebrospinal fluid for either Hx, X, or uric acid. We conclude that vitreous humor Hx and X increases more during IH than during CH.

Animals↗

[Local chemolysis of occluding uric acid calculi].

Between 1984 and 1986 nineteen patients (20 renal units) were admitted with obstructing uric acid calculi. Seventy-eight percent of all patients with urolithiasis were treated endourologically: 8 kidneys were infected, 8 kidneys were non-functioning and 3 kidneys caused a status colicus. Sodium bicarbonate was used for percutaneous irrigation and all 20 kidneys were cleared within 4 to 18 days. The technique is a valuable adjunct to the ESWL.

Aged↗

Increased plasma vasopressin and serum uric acid in the low renin type of essential hypertension.

In 22 50-year-old men with long-standing, untreated essential hypertension of the low renin type, venous plasma vasopressin concentrations were about three times those of 15 matched normotensive control subjects (p less than 0.005). These patients also had increased arterial concentrations of noradrenaline and adrenaline (p less than 0.05) but there was no direct association between these two catecholamines and vasopressin. On the other hand, adrenergic beta-receptor blockade with oxprenolol reduced both blood pressure and plasma vasopressin (p less than 0.01) while venous plasma dopamine concentrations significantly increased. In addition, the hypertensives had highly significantly increased serum uric acid (p less than 0.001) that correlated positively with venous vasopressin concentrations (p less than 0.05). According to these data, patients with the volume-sustained low renin type of essential hypertension have increased plasma vasopressin concentrations that probably are inversely related to dopaminergic nervous activity. The data also indicate that increased plasma vasopressin correlates with serum uric acid, most probably through increased tubular reabsorption of this acid.

Atenolol↗

Plasma endothelin levels in preeclampsia: elevation and correlation with uric acid levels and renal impairment.

OBJECTIVE: The purpose of this study was to determine if endothelin levels are elevated in women with preeclampsia and if these levels correlated with other laboratory features of disease severity. STUDY DESIGN: Parameters were compared in four groups of women volunteers by means of analysis of variance: (1) 16 women with preeclamptic pregnancies, (2) 11 pregnant women without preeclampsia, of similar lengths of gestation, (3) six otherwise normal women with pregnancies at term or beyond (greater than 38 weeks), and (4) 22 normotensive young women. RESULTS: Endothelin levels were elevated in women with preeclampsia as compared with those of gestation-matched pregnant and nonpregnant controls (22.6 +/- 2.0 vs 12.0 +/- 1.0 vs 10.4 +/- 1.3 pmol/L, p less than 0.005, preeclampsia vs controls) and also were increased in late gestation (17.7 +/- 2.0 pmol/L). Endothelin correlated positively with plasma levels of uric acid (r = 0.698, p less than 0.005) and inversely with creatinine clearance (r = -0.659, p less than 0.05). CONCLUSION: Circulating endothelin levels are elevated in women with preeclampsia and correlate closely with serum uric acid levels and measures of renal dysfunction. These observations suggest that endothelin may contribute to renal vasoconstriction in preeclampsia.

Adult↗

The relationship of weight change to changes in blood pressure, serum uric acid, cholesterol and glucose in the treatment of hypertension.

In the Hypertension Detection and Follow-up Program (HDFP), elevated blood pressure (BP) was treated by rigorous, stepped care (SC) therapy among half the participants, while the other half were referred to usual sources of care (referred care, RC). There was no program to reduce weight, however, some participants changed weight voluntarily over the first 2 yr, providing an opportunity to examine the role of weight change in the development of diuretic-induced hyperuricemia, hyperglycemia and hypercholesterolemia. There was a stepwise progression from decreased glucose, uric acid and cholesterol concentrations, and BP associated with maximum weight loss to increased values with maximum weight gain. In SC, systolic BP declined by 22.4% among weight-losers and by 17.1% among weight-gainers; in RC, it was 14.4 and 8.1%, respectively. The pattern in diastolic blood pressure and weight change was similar but not as marked. These findings suggest the potential importance of weight loss in enhancing effectiveness of antihypertensive drug treatment and attenuating increases in glucose, uric acid, and cholesterol associated with diuretic treatment of hypertension. The weight change analyses are based on postrandomization observations and do not reflect experimental changes.

Blood Glucose↗

Dissociation between uric acid and urea clearances in the syndrome of inappropriate secretion of antidiuretic hormone related to salt excretion.

1. Our purpose was to determine why hypouricaemia is more frequently observed than hypouraemia in the syndrome of inappropriate secretion of antidiuretic hormone. We have retrospectively analysed the scores of 35 patients with a chronic form of hyponatraemia related to the syndrome of inappropriate secretion of antidiuretic hormone and studied prospectively six patients. 2. The patients with high fractional excretion of filtered urea (greater than 55%) presented lower blood urea and lower salt excretion than the patients with normal fractional excretion of filtered urea, despite similar levels of hyponatraemia and of osmotic and uric acid clearances. In six hyponatraemic patients, an increase in salt intake was accompanied by a decrease in fractional excretion of filtered urea. In the syndrome of inappropriate secretion of antidiuretic hormone, the fractional excretion of filtered urea was inversely correlated to the fractional excretion of filtered sodium (r = -0.66; P less than 0.001), whereas the fractional excretion of filtered uric acid was not dependent on sodium excretion. 3. Hypouraemia with high fractional excretion of filtered urea in patients with the syndrome of inappropriate secretion of antidiuretic hormone is related to low urinary sodium excretion and thus reflects low sodium intake.

Adult↗

Allantoin, the oxidation product of uric acid is present in chicken and turkey plasma.

Urate oxidase is not present in birds yet allantoin, a product of this enzyme, has been measured in birds. Studies were designed to compare the concentrations of plasma purine derivatives in chickens and turkeys fed inosine-supplemented diets. The first study consisted of 12 male chicks that were fed diets supplemented with 0.6 mol inosine or hypoxanthine per kilogram diet from 3- to 6-week-old. Study 2 consisted of 12 turkey poults (toms) fed inosine-supplemented diets (0.7 mol/kg) from 6- to 8-week-old. Plasma allantoin and oxypurines concentrations were measured weekly using high performance liquid chromatography. Plasma uric acid (PUA) in chickens fed inosine-supplemented diets increased from 0.31 to 1.34 mM (P<0.05) at the end of week 2. In turkeys, those fed control diet had 0.17 mM PUA concentration compared to 0.3 mM in those fed the inosine diet at week 2 (P<0.05). Allantoin concentration increased in chickens from week 1 to 2 while a decrease was observed in turkeys (P<0.005) for both treatments. These data show that allantoin is present in turkey and chicken plasma. The presence of allantoin in avian plasma is consistent with uric acid acting as an antioxidant in these species.

Allantoin↗

[Practical experiences with antegrade local chemolysis of struvite/apatite, uric acid and cystine calculi in the kidney].

In 18 patients (20 kidneys) with struvite/apatite-, uric acid- and cystine stones antegrade local chemolysis was performed via percutaneous or operative nephrostomy. Complete stone dissolution was achieved in 11 kidneys, while in six kidneys partial dissolution of stones was performed. In these six cases added instrumental manipulations shortened the time of therapy. In three cases chemolysis was unsuccessful. Average irrigation time was 21 days per renal unit. Only minor complications like dysuria and skin rashes were seen. Due to long time of irrigation we recommend chemolitholysis mainly as an additional form of therapy in case of residual stones after operative or percutaneous nephrolithotomy.

Acetylcysteine↗

Elevated serum uric acid levels in metabolic syndrome: an active component or an innocent bystander?

Elevated serum uric acid (SUA) levels are commonly seen in patients with the metabolic syndrome (MetS). Several mechanisms, both direct and indirect, connect the increased SUA levels with the established diagnostic criteria of MetS. It is possible that the increased cardiovascular disease risk associated with the MetS is partially attributed to elevated circulating SUA concentration. Several drugs used in the treatment of MetS may alter SUA levels. Thus, lifestyle measures together with the judicious selection of drugs for the treatment of hypertension, dyslipidemia, and insulin resistance associated with MetS may result in a reduction of SUA levels and possibly cardiovascular disease risk. This review summarizes the pathophysiologic association between SUA and MetS and focuses on the prevention of hyperuricemia and its cardiovascular consequences.

Animals↗

Oral zinc therapy normalizes serum uric acid level in Wilson's disease patients.

The authors investigated changes in the serum uric acid (s-UrA) level seen in a Wilson's disease patient who had to undergo oral zinc therapy because of the occurrence of D-penicillamine-induced acute sensitivity reactions, including neutrophilic agranulocytosis, thrombocytopenia, and skin eruptions. Although s-UrA levels were low before oral zinc therapy (mean +/- SD, 1.60 +/- 0.20), they increased (mean +/- SD, 2.63 +/- 0.32) to within normal range (2.8-8.0 mg/dl) after therapy. There were no significant changes in the renal tubular reabsorption of UrA during oral zinc therapy. This therapy also produced an improvement of the decreased cholinesterase (ChE) values usually seen in Wilson's disease. These results suggest that oral zinc therapy can normalize UrA metabolism in Wilson's disease by improving liver dysfunction and increasing UrA synthesis.

Administration, Oral↗

Serum uric acid: not a discriminator of coronary heart disease in men and women.

Fasting serum uric acid (SUA) was measured using a spectrophotometric method in 635 randomized male subjects aged 20 to 70, as part of an epidemiological study carried our among the civil employees of French origin working for the City of Montreal. It was observed that SUA was not age-dependent and that the overall mean value was 6.26 mg./100 ml. On the other hand SUA was studied in 742 males and 260 females, all of whom had had coronarography. A significant difference in SUA between males and females of 1.26 mg./100 ml. was noted. Correlating the SUA levels with the incidence of CHD or the severity of the lesions in the coronary arteries indicated no relationship between CHD and SUA concentrations in men or in women. The results of this study permit the conclusion that SUA is not a discriminator for CHD.

Adult↗

Radicals derived from uric acid and its methyl derivatives in aqueous solution: an EPR spectroscopy and theoretical study.

The oxidation of uric and of four N-methyluric acids in aqueous solution was studied by EPR spectroscopy. The primary oxidising radicals react with uric acid and its methyl derivatives by formal hydrogen abstraction from an NH group to yield radical-anions in neutral or moderately basic solutions and the respective radical-dianions in basic media. In the case of uric acid, the radical-trianion was detected at very high pH. The pKa values of the radical-anions were determined to be in the range 9.5-11.2. The pKa of uric acid radical-dianion was estimated to be 13.0. DFT calculations were performed to assign the hyperfine coupling constants and to determine the predominant tautomeric structure of the radicals. The uric acid radical-anion exists as the N1H, N9H tautomer, while in the radical-dianion the N1H structure is the most stable one. The intrinsic acidity of the NH protons both in uric acid and in its radicals seems to follow the order N1H < N9H < N3H.

Journal Article↗

Urinary uric acid excretion in term and premature infants.

OBJECTIVE: To clarify postnatal changes in urinary uric acid (UA) excretion in normal term infants and to examine the effects of prematurity or illness on the UA excretion. METHODOLOGY: Measurements of urinary UA were performed in term and premature infants at the ages of 1 and 7 days and at 1 and 4 months, as well as 7 months in term infants. RESULTS: Urinary UA levels were lowest on day 7 in term infants. The levels were highest on day 1 in premature infants and remained significantly higher compared to term babies during the first month of life. Respiratory failure requiring ventilation and oxygen supply resulted in further significant elevation of urinary UA in premature infants. CONCLUSIONS: With the reference values obtained in the study reported here, urinary UA can now be used for the diagnosis and monitoring of inherited disorders of purine metabolism and for the assessment of oxygen radical insult to sick infants.

Age Factors↗