Renal urate transport.
Serum uric acid is determined by a balance between production and renal excretion. Luminal reabsorption of urate by the proximal tubule from the glomerular ultrafiltrate involves coupling between sodium-anion cotransport and urate-anion exchange. Apical sodium-coupled cotransport of lactate, ketoacids, nicotinate, and pyrazinoate increases intracellular levels of these anions in proximal tubular cells, stimulating the apical absorption of luminal urate via anion exchange. Hyperuricemia occurs when plasma levels of these anions increase; for example, hyperuricemia is a well-recognized concomitant of lactic acidosis and ketoacidosis. Relevant developments in the molecular and renal physiology of urate homeostasis are reviewed.
Mount
David B
DB
Harvard Medical School, Boston, MA, USA. dmount@rics.bwh.harvard.edu
Kwon
Charles Y
CY
Zandi-Nejad
Kambiz
K
D000818:Animals; D001693:Biological Transport, Active; D002352:Carrier Proteins / Q000378:metabolism; D006073:Gout / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007687:Kidney Tubules, Proximal / Q000378:metabolism*; D027361:Organic Anion Transporters / Q000378:metabolism; D027701:Organic Cation Transport Proteins; D014527:Uric Acid / Q000378:metabolism*
D002352:Carrier Proteins; D027361:Organic Anion Transporters; D027701:Organic Cation Transport Proteins; C491241:SLC22A12 protein, human; D014527:Uric Acid