Baldree L A, Stapleton F B
Department of Pediatrics, University of Tennessee, Memphis.
Pediatr Clin North Am. 1990 Apr;37(2):391-418. doi: 10.1016/s0031-3955(16)36876-6.
The renal excretion of uric acid in children differs quantitatively, and perhaps qualitatively, from that in adult humans. The younger the child, the greater the renal clearance of uric acid and the greater the excretion of uric acid expressed as mg per kg body weight. During infancy, the reduced ability to maximally concentrate the urine may protect against precipitation of uric acid crystals within the kidney. Conversely, the extremely high urinary uric concentrations places the very small infant at jeopardy during sudden increases in the filtered load of uric acid. Understanding the pharmacologic and physiologic modulators of renal uric acid clearance will allow the pediatrician to minimize the risk of uric acid nephropathy, and to understand the implications of uric acid in the serum or urine in children with fluid and electrolyte disorders. Certainly evaluation of serum and urinary uric acid concentrations is essential in any child with acute renal failure.
儿童尿酸的肾脏排泄在数量上，甚至可能在质量上，都与成人不同。儿童年龄越小，尿酸的肾脏清除率越高，以每千克体重毫克数表示的尿酸排泄量也越大。在婴儿期，最大程度浓缩尿液的能力降低可能有助于防止尿酸晶体在肾脏内沉淀。相反，极高的尿尿酸浓度使极小的婴儿在尿酸滤过负荷突然增加时处于危险之中。了解肾脏尿酸清除的药理学和生理学调节因素将有助于儿科医生将尿酸肾病的风险降至最低，并理解尿酸在患有液体和电解质紊乱的儿童血清或尿液中的意义。当然，对于任何急性肾衰竭患儿，评估血清和尿尿酸浓度都是至关重要的。
