Uric acid metabolism in patients with chronic renal failure under maintenance hemodialysis

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We investigated the serum levels of uric acid in 70 patients under maintenance hemodialysis in comparison with the serum levels of creatinine before and after the one session of hemodialysis.<BR>There were no significant correlations between serum levels of uric acid and creatinine before hemodialysis nor between the former and the duration from the initiation of hemodialysis, although the serum uric acid levels were elevated in almost all patients (9.21±2.15mg/dl, n=70) compared with normal levels (5.32±1.15mg/dl, n=58).<BR>The mean ratios of serum uric acid to creatinine levels before hemodialysis were significantly lower (p<0.01)in the hemodialysis group (0.70±0.25) than in 58 normal control subjects (8.74±3.41) and in 58 pattients with chronic renal failure on conservative therapy (2.69±1.78).<BR>As the interval between the hemodialysis sessions was longer, the rate of elevation of serum uric acid levels from the end of one session until the next one become lower, and the rate showed a significant correlation (r=-0.517, p <0.01, n=15) with the serum creatinine levels before hemodialysis.<BR>These results indicate that some mechanism inhibits the elevation of serum uric acid level in uremia in spite of the elevation of serum creatinine level, such as a promoter to enter uric acid into cells or tissues and an inhibitor to produce uric acid in the liver.
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