Influence of cyclosporin A (CyA) on renal handling of urate.
Hyperuricaemia is a frequent side-effect of cyclosporin A (CyA) therapy in renal transplant patients, and gout arthritis is the cause of considerable morbidity among these patients. However, neither the potential predisposing factors nor the mechanisms of hyperuricaemia have been clearly elucidated. It has been reported that hyperuricaemia in patients on CyA is associated with a lowered glomerular filtration rate, or with a reduced urate clearance, due to an increase in the net tubular urate reabsorption or to a decrease in secretion. These conclusions are mostly supported by measurements of the basal clearance rate and fractional excretion of urate, but more precise studies of renal handling of urate by the renal tubule have seldom been performed. The purpose of our study was to investigate the prevalence of hyperuricaemia in our population of renal transplant patients, as well as the risk factors involved. Furthermore, we have evaluated the mechanism of hyperuricaemia by a combined pyrazinamide and probenecid test allowing a better evaluation of urate transport processes than pyrazinamide alone.
Marcén
R
R
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Gallego
N
N
Orofino
L
L
Sabater
J
J
Pascual
J
J
Teruel
J L
JL
Liaño
F
F
Ortuño
J
J
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033461:Hyperuricemia / Q000139:chemically induced* / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors; D014527:Uric Acid / Q000652:urine*
D004232:Diuretics; D007166:Immunosuppressive Agents; D014527:Uric Acid; D016572:Cyclosporine; D001379:Azathioprine