Document Detail

Overnight urinary uric acid: creatinine ratio for detection of sleep hypoxemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure.
MedLine Citation:
PMID:  8317794     Owner:  NLM     Status:  MEDLINE    
During hypoxia ATP degradation to uric acid is increased in animal models and humans. To assess the reliability of an overnight increase in uric acid excretion as a marker of nocturnal hypoxemia, we selected 10 normal volunteers (7 males and 3 females), 29 COPD patients (26 males and 3 females), and 49 subjects with obstructive sleep apnea (OSA) (43 males and 6 females). The patients underwent standard polysomnography, which was repeated in 14 subjects with nasal continuous positive airway pressure (CPAP), and were subdivided into two groups: Group D included desaturating subjects who spent at least 1 h at SaO2 < 90% and 15 min below 85%, and Group ND were nondesaturating subjects. The overnight change in the uric acid:creatinine ratio (delta UA:Cr) was negative in normal subjects (-27.5 +/- 9.1 [mean +/- SD]) and ND groups: -19.7 +/- 14.3 in COPD, -16.1 +/- 13.0 in OSA. In both COPD and OSA Group D, the ratio was usually positive: delta UA:Cr was 17.9 +/- 31.4 in Group D COPD (p < 0.001 versus ND) and 10.1 +/- 30.7 in Group D OSA (p < 0.001 versus ND and versus normal subjects) despite 4 of 15 false negative results in COPD and 8 of 20 in OSA. CPAP effective treatment induced a marked reduction ((p = 0.0024) in delta UA:Cr, leading to a negative value. We conclude that delta UA:Cr seems to be a promising index of significant nocturnal tissue hypoxia, with good specificity but poor sensitivity (about 30% false negative), which might be useful for the long-term follow-up of outpatients on nasal CPAP with a positive ratio at baseline.
A Braghiroli; C Sacco; M Erbetta; V Ruga; C F Donner
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  148     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-07-28     Completed Date:  1993-07-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  173-8     Citation Subset:  AIM; IM    
Division of Pulmonary Disease, IRCCS, Medical Rehabilitation Center, Veruno, Novara, Italy.
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MeSH Terms
Analysis of Variance
Anoxia / epidemiology,  therapy,  urine*
Circadian Rhythm / physiology*
Creatinine / urine*
Lung Diseases, Obstructive / epidemiology,  therapy,  urine*
Middle Aged
Polysomnography / statistics & numerical data
Positive-Pressure Respiration* / statistics & numerical data
Regression Analysis
Sleep Apnea Syndromes / epidemiology,  therapy,  urine*
Uric Acid / urine*
Reg. No./Substance:
60-27-5/Creatinine; 69-93-2/Uric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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