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

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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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Acknowledgments

FPR and AMHB were partially funded by Asociación de Reumatólogos del Hospital de Cruces.

Conflict of interest

None.

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Authors and Affiliations

  1. Rheumatology Division, Hospital Universitario Cruces and BioCruces Health Research Institute, Pza. Cruces sn, 48903, Baracaldo, Spain

    Fernando Perez-Ruiz

  2. Biochemistry Department, Hospital Universitario Cruces, Baracaldo, Spain

    Maria Angeles Aniel-Quiroga

  3. Rehabilitation Division, Hospital de Górliz, Górliz, Spain

    Ana María Herrero-Beites

  4. Rheumatology Division, Hospital Universitario Cruces, Baracaldo, Spain

    Sandra Pamela Chinchilla

  5. Nephrology Division, Hospital Universitario Cruces, Baracaldo, Spain

    Gorka Garcia Erauskin

  6. Biochemistry Department, University of Otago, Otago, New Zealand

    Toni Merriman

Authors
  1. Fernando Perez-Ruiz
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  2. Maria Angeles Aniel-Quiroga
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  3. Ana María Herrero-Beites
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  4. Sandra Pamela Chinchilla
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  5. Gorka Garcia Erauskin
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  6. Toni Merriman
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Correspondence to Fernando Perez-Ruiz.

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Perez-Ruiz, F., Aniel-Quiroga, M.A., Herrero-Beites, A.M. et al. Renal clearance of uric acid is linked to insulin resistance and lower excretion of sodium in gout patients. Rheumatol Int 35, 1519–1524 (2015). https://doi.org/10.1007/s00296-015-3242-0

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  • DOI: https://doi.org/10.1007/s00296-015-3242-0

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