Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Renal Handling of Urate in Two Patients with Hyperuricemia and Primary Hyperparathyroidism
Ichiro HISATOMEMasahiko ISHIMURANorito SASAKIMasayuki YAMAKAWAHiromoto KOSAKAYasushi TANAKATetsuo KOUCHIYasuo MITANIAkio YOSHIDAHiroshi KOTAKEChiaki SHIGEMASAHiroto MASHIBA
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1992 Volume 31 Issue 6 Pages 807-811

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Abstract

Two patients with primary hyperparathyroidism had hyperuricemia due to the decrease in urate clearance. In analysis by 4-component model system, the tubular secretion of urate commonly decreased without changes in either filtered urate or presecretory reabsorption of urate. Both patients had a reduction of urea clearance, and both parathyroidectomy in the former case and intravenous infusion of saline in the latter case could reduce the serum urate level associated with the increase in the ratio of urate clearance to creatinine clearance. It is of interest that the former case with a higher serum urate level had a relatively higher postsecretory reabsorption, even with the decrease in tubular secretion of urate. However, the latter patient with a lower serum urate level had a decrease in postsecretory reabsorption of urate in proportion to the decrease in tubular secretion. These results suggest that in hyperuricemia patients with primary hyperparathyroidism, the reduction of tubular urate secretion via hypoperfusion of the capillary network is typically present, however, the severity of the hyperuricemia might be dependent on the dysfunction of the postsecretory reabsorption of urate.
(Internal Medicine 31 : 807-811, 1992)

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