Urolithiasis and Urate Metabolism
スポンサーリンク
概要
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There has been no indices to decide a suitable prophylaxic management for error of urate metabolism. It is not possible under present conditions to establish the precise definition even using serum and urinary uric acid level. Therefore, we have aimed in the present studies to elucidate an index to take measures for prophylaxis in metabolic error.<BR>The cocentration of serum uric acid and the excretion of urine uric acid were determined in 161 cases of normal human. Urine uric acid level was 660.7±169.8 mg/24 hrs (M±S.D.) in 120 normal males and 593.6±147.9 mg/24 hrs (M±S.D.) in 41normal females. Furthermore, it was concluded that there was significant correlation between urine uric acid level and creatinine clearance rate. The ratio of urine uric acid per creatinine clearance rate (Uur/Ccrea) was 8.6±1.8 (M±S.D.) in l20normal males and 7.5±1.6 (M±S.D.) in 41 normal females. The standard deviation in Uur/Crea showed markedly lesser value than that in urine uric acid level. It is strongly suggested that Uur/Crea may become an useful index for prophylaxic management in patients with the metabolic error.<BR>Based on this, Uur/Ccrea in 363 patients with urolithiasis were determined.<BR>Furthermore,78 cases with the metabolic error were treated with allopurinol in part probenecid for one to 14 years. Getting together, the results were summarized as follows.<BR>1) In generally, the treatment with allopurinol revealed a tendency to decrease in formation of stone. Especially, in patients with pure uric acid urolithiasis and other stones with gouty attack, the treatment could completely prevent for recurrent stone.<BR>2) Recurrent formation of stone as recognized in 11 cases during the treatment, Uur/Ccrea in 8 patients out of cases, who were made diagnosis of hyperuricosuria, remained within normal range.3 out of the cases had chronic urinary infection.<BR>It is resulted in the present studies that Uur/Ccrea may be an effective marker to detect the patient who should be appropriated the long term treatment for error of urate metabolism.
- Japanese Society of Gout and Nucleic Acid Metabolismの論文