Abstract
The hyperuricemia associated with CsA therapy was studied in 400 renal transplant recipients receiving either prednisone-cyclosporine (PC, n=122) or prednisone-azathioprine (PA, n=176). When the serum creatinine was less than 2 mg%, hyperuricemia was more common in the PC group (65.8%) than in the PA group (23.3%, p≤ .005) and the mean serum urate was greater in the PC than the PA group (8.24 ± 2.43 mg% vs. 6.35 ± 1.61 mg%, p ≤ .005). Serum urate was greater in the PC than in the PA group at all levels of renal function (p=.032). Seventy-nine percent of PC patients treated with diuretic had elevated serum urate compared to 48% in those not receiving diuretic (p ≤ 0.01), the respective values in the PA group were 37% vs. 11% (p ≤ 0.005). Twelve individuals (PC n=6, PA n=2, normal volunteers n=4) had extended studies of urate metabolism. PC patients had large urate pools (493–998 mg/m2/d) and a normal rate of turnover (275–410 mg/m2/d). The urate clearance in PC patients ranged between 2.00 and 3.96 ml/min while it was between 4.83 and 8.23 ml/min in the others. Enzyme activity of HGPRT and APRT were normal in all individuals. We conclude that hyperuricemia in CsA treated renal allograft recipients is due to decreased renal urate excretion related to the drug and exacerbated by concommitant diuretic use.
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Lin, H., Rocher, L., McQuillan, M. et al. 35 HYPERURICEMIA IN CYCLOSPORINE (CsA) TREATED RENAL ALLOGRAFT RECIPIENTS: EVIDENCE FOR UNDEREXCRETION OF URATE. Pediatr Res 24, 117 (1988). https://doi.org/10.1203/00006450-198807000-00059
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DOI: https://doi.org/10.1203/00006450-198807000-00059