1988 Volume 30 Issue 1 Pages 59-65
Hyperuricemia and urinary uratic sedimentation due to hyperuricaciduria are conceivably main factors in the onset and aggravation of renal disorders in gout. We have measured intrarenal uric acid concentrations in the autopsied patients with primary gout in an attempt to clarify a mechanism in the onset and aggravation of renal disorders. The subjects were 7 patients with primary gout, 7 with chronic renal insufficiency exhibiting secondary hyperuricemia in a non-dialyzed group, 9 in a dialyzed group and 11 in a control group (serum uric acid not more than 7 mg/100 ml and Ccr not less than 60 ml/min), Uric acid concentrations in the renal cortex, juxtamedulla and medulla were measured by the HPLC-ECD method. As a result, intrarenal uric acid concentrations in a group of gout were higher than that in a control group in any of these regions, and the intrarenal uric acid concentrations were higher in the medulla than in the cortex and 3 times higher in the medulla than that in a control. Although serum uric acids showed higher levels in a non-dialyzed group, intrarenal uric acid concentrations were almost similar to that in a control, and tended to be lower in the medulla than in the cortex. This trend was more significant in the dialyzed group than in the non-dialyzed group. intrarenal uric acid concentrations in the patients with gout were also proved higher even when histological uric acid and urate deposit could not be verified. Thus, the measure-ment of uric acid concentrations were considered useful for clarifying a mechanism in the development of renal disorders in the patients with gout.
