Hyperuricemia in pre-eclampsia. A reappraisal.
Seventeen pre-eclamptic (PE), 22 hypertensive (H), and 13 normal pregnant women (C), all in the third trimester, were studied to examine the relationship of blood lactate (L) to the hyperuricemia characteristic of PE. The parameters measured were: serum and urinary uric acid, and creatinine, and lactate (L), and pyruvate (P) in the blood. Uric acid clearance (Cur), and creatinine clearance (Ccr), and fractional uric acid clearance (Fract. Cur) as well as L/P ratios were calculated. Some of the patients, from the three groups, were infused with approximately equal to 100 mEq. of sodium lactate during the course of 50 minutes. "Preinfusion," "midinfusion," and "postinfusion," determinations were compared, as well as the per cent change in the different parameters as the result of the infusion and after its discontinuation. The results showed that serum urine acid is elevated, and Cur is impaired in PE; however, L was lower in PE than in control subjects. There was no correlation between L or L/P and Cur. Lactate infusion caused comparable impairment of Cur in all groups. There was no significant difference in the response of the parameters studied, to the infusion, between the different groups. Our data cast serious doubts on the postulated role of blood lactate in the etiology of hyperuricemia in PE. Contracted plasma volume and/or local release of angiotensin II in the kidney of pre-eclamptic patients probably play a more important role.
D000042:Absorption; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D005110:Extracellular Space / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000097:blood; D007606:Juxtaglomerular Apparatus / Q000166:cytology; D007668:Kidney / Q000378:metabolism; D007684:Kidney Tubules / Q000378:metabolism; D007773:Lactates / Q000097:blood; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood; D011263:Pregnancy Trimester, Third; D011773:Pyruvates / Q000097:blood; D012964:Sodium / Q000378:metabolism; D014527:Uric Acid / Q000097:blood* / Q000378:metabolism
D007773:Lactates; D011773:Pyruvates; D014527:Uric Acid; D012964:Sodium; D003404:Creatinine