Hisatome I, Kato T, Miyakoda H, Takami T, Abe T, Tanaka Y, Kosaka H, Ogino K, Mitani Y, Yoshida A
1st Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Nephron. 1993;64(3):447-51. doi: 10.1159/000187369.
Renal handling of urate in the hypouricemic patient with increase in both urate clearance (Cur) and Cur/creatinine clearance (Ccr) and normal urinary excretion of urate was studied according to the pharmacological evaluation. In the present case there was no response of urate excretion to either pyrazinamide or probenecid. Both furosemide and prednisolone could not alter Cur and Cur/Ccr. Administration of inosine could have increased Cur, which was greater than Ccr. These results suggest that the present case had the defect of both pre- and postsecretory reabsorption of urate, accompanied by the existence of drug-insensitive secretion of urate, which is different from hitherto known types of renal hypouricemia, i.e. a novel type of renal hypouricemia.
根据药理学评估，对尿酸清除率（Cur）和Cur/肌酐清除率（Ccr）均升高且尿酸尿排泄正常的低尿酸血症患者的尿酸肾脏处理情况进行了研究。在本病例中，尿酸排泄对吡嗪酰胺或丙磺舒均无反应。呋塞米和泼尼松龙均不能改变Cur和Cur/Ccr。给予肌苷可使Cur升高，且升高幅度大于Ccr。这些结果表明，本病例存在尿酸分泌前和分泌后重吸收缺陷，并伴有对药物不敏感的尿酸分泌，这与迄今已知的肾性低尿酸血症类型不同，即一种新型的肾性低尿酸血症。
