The relationship between uric acid and potassium in normal subjects

Plasma and skeletal muscle electrolytes in patients on long-term diuretic therapy for arterial hypertension and/or congestive heart failure

Investigations regarding plasma and skeletal muscle electrolytes were carried out in 537 patients on long-term diuretic treatment (greater than 1 year) for arterial hypertension (n = 240) and/or congestive heart failure (n = 297). In both groups there were significant decreases in both plasma and skeletal muscle K and Mg, while the muscle Na values as well as the total and extracellular water content of skeletal muscle were increased.

Uric acid metabolism in children

The renal excretion of uric acid in children differs quantitatively, and perhaps qualitatively, from that in adult humans. The younger the child, the greater the renal clearance of uric acid and the greater the excretion of uric acid expressed as mg per kg body weight. During infancy, the reduced ability to maximally concentrate the urine may protect against precipitation of uric acid crystals within the kidney. Conversely, the extremely high urinary uric concentrations places the very small infant at jeopardy during sudden increases in the filtered load of uric acid. Understanding the pharmacologic and physiologic modulators of renal uric acid clearance will allow the pediatrician to minimize the risk of uric acid nephropathy, and to understand the implications of uric acid in the serum or urine in children with fluid and electrolyte disorders. Certainly evaluation of serum and urinary uric acid concentrations is essential in any child with acute renal failure.

Altered erythrocyte and plasma sodium and potassium in hypertension, a facet of hyperinsulinemia

Red blood cell sodium and potassium, plasma potassium, glucose and insulin responses to oral glucose load, serum urate, and plasma triglycerides were determined in a stratified subsample (n = 89) of a representative population sample (n = 1211), comprising 30 nonobese normotensive subjects with normal glucose tolerance (reference group) and 59 subjects representing each of the seven possible combinations of abnormal glucose tolerance, obesity, and hypertension. Rate of cation imbalance (red blood cell sodium greater than or equal to 7.0 mEq/L, potassium less than 92.5 mEq/L, or plasma potassium greater than or equal to 4.5 mEq/L) was 88.1% in subjects with abnormal tolerance, obesity, or hypertension, as compared with 40.0% in the reference group (p less than 0.001). These subjects were also characterized by significantly greater rates of insulin response: 60- and 120-minute postload levels of 100 mU/L or more (88.1 vs 46.7%), plasma triglycerides of 80 mg/dl or more (89.8 vs 53.3%) and serum uric acid of 5.5 mg/dl or more (61.0 vs 26.7%; p less than 0.001 for all). The rate of cation imbalance was significantly associated with each of these three biochemical correlates: insulin response (p less than 0.01), triglycerides (p less than 0.001), and urate (p less than 0.001). In the total population sample, the rate of untreated hypertension increased from 18% to 35% to 55.3% (p less than 0.001), with an increase in the number of biochemical correlates of cation imbalance in combination with glucose intolerance and obesity.(ABSTRACT TRUNCATED AT 250 WORDS)

High uric acid as an indicator of cardiovascular disease. Independence from obesity

In three groups of patients, we investigated the hypothesis that body weight is not the factor underlying the relation between hyperuricemia and cardiovascular disease. Among 111 subjects with asymptomatic hyperuricemia followed for 108 months, atherosclerotic heart disease (ASHD) developed in six; their mean was 77.4 kg (172 pounds) compared with 79.7 kg (177 pounds) in the remainder; in 25 of the 111 patients hypertension developed; their mean weight was not significantly higher than that of the remainder. Among 156 patients with established gout followed for 133 months, clinical atherosclerosis developed in 25 after a mean of 95 months; their mean weight was 78.3 kg (174 pounds) contrasted with 79.7 kg (177 pounds) in those 81 of the remaining patients who had a weight recorded with 75 +/- 12 months after their initial attack of gout. Among 1,356 men aaged 60 to 69 years who had their serum uric acid recorded in 1967, subsequent deaths from cardiovascular disease showed a stepwise increase when deaths were arranged according to the serum uric acid levels but not when they were arranged according to body weight. Hyperuricemia thus predicts future cardiovascular disease independently of body weight.