Clinical Rheumatology

, Volume 35, Issue 1, pp 133–141 | Cite as

Influence of urate-lowering therapies on renal handling of uric acid

  • Lili Ma
  • Lei Wei
  • Huiyong Chen
  • Zhuojun Zhang
  • Qiang Yu
  • Zongfei Ji
  • Lindi Jiang
Original Article


The purpose of this study is to investigate the effect of urate-lowering therapies (ULTs) on renal uric acid excretion in gout patients. This prospective observational study involved 106 primary gout patients and 51 healthy controls. Gout patients received ULT with either xanthine oxidase inhibitors or the uricosuric agent benzbromarone. Parameters such as 24-h urinary uric acid, creatinine clearance, uric acid clearance, glomerular filtration load of uric acid, fractional excretion of uric acid, excretion of uric acid per volume of glomerular filtration, and urinary uric acid to urinary creatinine ratio were used to evaluate the pre- and post-treatment renal capacity for uric acid clearance in gout patients and were compared with the values in the healthy controls. Compared to healthy controls, gout patients had higher glomerular filtration load of uric acid and lower uric acid clearance, creatinine clearance, and fractional uric acid excretion. After ULT, both the xanthine oxidase inhibitor group and benzbromarone group patients showed reduction in glomerular filtration load of uric acid. Creatinine clearance was significantly improved in the xanthine oxidase inhibitor group. Excretion function was remarkably enhanced in patients who reached the treatment target (serum uric acid <6 mg/dl). Changes in glomerular uric acid filtration load were significantly correlated with changes in serum urate levels. Gout patients have impaired renal uric acid excretion. ULTs reduce renal urate load and enhance the renal capacity of uric acid clearance. Xanthine oxidase inhibitors showed superiority over benzbromarone in improving renal function.


Gout Treat to target Uric acid Uricosuric agent Xanthine oxidase inhibitors 



Glomerular filtration rate


Urate-lowering therapy


Xanthine oxidase inhibitors


Clearance of creatinine


Clearance of uric acid


Fractional excretion of uric acid


Glomerular filtration load of uric acid


Urinary uric acid to Urinary creatinine ratio


American College of Rheumatology


Acute kidney injury


Renin-angiotensin system


Angiotensin receptor blockers


Chronic kidney disease


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2014

Authors and Affiliations

  • Lili Ma
    • 1
  • Lei Wei
    • 1
  • Huiyong Chen
    • 1
  • Zhuojun Zhang
    • 1
  • Qiang Yu
    • 1
  • Zongfei Ji
    • 1
  • Lindi Jiang
    • 1
  1. 1.Department of RheumatologyZhongshan HospitalShanghaiPeople’s Republic of China

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