Ultrafiltrable uric acid in serum of healthy humans and patients with renal calcium lithiasis.

Ultrafiltrable serum uric acid (u.a.) was determined by ultrafiltration under in vivo conditions in humans using a reliable technique described in detail. It could be demonstrated that u.a. binding to macromolecules occurs in healthy humans (controls) and in patients with renal calcium stones. The percentage of free u.a. in controls (n=60) averages 86.2 +/- 0.9 SEM. With increasing age, bound u.a. rises slightly. On the other hand, younger (less than 40 years) stone patients have significantly more bound u.a. than matched controls (80.7 +/- 1.0 SEM; p less than 0.001), whereas this is not found in elderly patients. The degree of binding is not related to concentration of plasma proteins but inversely related to free fatty acid concentration in healthy controls (r= -0.52; p less than 0.01). It is suggested that no augmentation of tubular u.a. filtered by the glomeruli could have occurred. The origin of fasting hyperuricosuria shown earlier to be a prominent feature of young renal calcium stone formers is yet unknown.