Document Detail


Risk factors associated with renal lithiasis during uricosuric treatment of hyperuricemia in patients with gout.
MedLine Citation:
PMID:  20506124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To find factors associated with the development of renal colic during uricosuric therapy. METHODS: We performed a prospective cohort followup study of patients with gout and no previous history of kidney stones who had been treated with uricosurics. Clearance of creatinine and urate, 24-hour urinary uric acid (UA), undissociated urinary UA concentration, 24-hour undissociated urinary UA, and pH and urine sediment were obtained. Cox proportional hazards regression analysis was used to identify variables associated with renal colic as the outcome. The rate of renal colic was compared with that of control patients receiving allopurinol who had no previous history of renal stones. RESULTS: We analyzed a 784 patient-year exposure from 216 patients: 206 with renal underexcretion of UA and 10 with normal excretion. There were 21 clinical events. Two variables showed increased risk hazard for developing lithiasis: clearance of UA at baseline and undissociated urinary UA concentration during followup. When only patients with underexcretion of UA were included in the analysis, undissociated urinary UA during followup remained the only statistically significant variable. Patients who showed an undissociated UA concentration < 20 mg/dl did not show an increase in the rate of lithiasis or events compared with patients receiving allopurinol. CONCLUSION: Clearance of UA at baseline may be useful for selecting patients suitable for uricosuric treatment. The estimation of the concentration of undissociated urinary UA is useful for evaluating the risk of lithiasis during followup.
Authors:
Fernando Perez-Ruiz; Samuel Hernandez-Baldizon; Ana M Herrero-Beites; Miguel A Gonzalez-Gay
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis care & research     Volume:  62     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-20     Completed Date:  2010-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1299-305     Citation Subset:  IM    
Affiliation:
Hospital de Cruces, Vizcaya, Spain. fernando.perezruiz@osakidetza.net
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MeSH Terms
Descriptor/Qualifier:
Allopurinol / adverse effects,  therapeutic use
Benzbromarone / adverse effects,  therapeutic use
Cohort Studies
Creatinine / urine
Follow-Up Studies
Gout / complications,  drug therapy*
Humans
Hyperuricemia / complications,  drug therapy*
Middle Aged
Proportional Hazards Models
Prospective Studies
Renal Colic / etiology*
Risk Factors
Time Factors
Uric Acid / urine
Uricosuric Agents / adverse effects*,  therapeutic use
Urolithiasis / chemically induced,  etiology*
Chemical
Reg. No./Substance:
0/Uricosuric Agents; 315-30-0/Allopurinol; 3562-84-3/Benzbromarone; 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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