Methods: A total of 168 patients were included in this study. Serum uric acid (SUA), serum creatinine (Scr), 24 hour urine uric acid (24h UUA), 24 hour urine creatinine (24h Ucr), and urine volume were measured before and 1 month after urate-lowering therapy. Urate excretion indicators including 24h UUA, Clearance of uric acid (Cur), fractional excretion of uric acid (FEUA), excretion of uric acid per volume of glomerular filtration (EurGF), and ratio of urinary uric acid to creatinine (UUA/Ucr) were calculated.
Results: The percentages of 24 UUA<800.00 mg, Cur<6.20 ml/min and FEUA<7.00% were 75.45% (126/167), 95.81% (160/167) and 85.45% (141/165) respectively among gout patients. Correlation analysis showed that SUA level was positively correlated with 24h UUA (r=0.17, P=0.025), EurGF (r=0.31, P<0.001) and Scr (r=0.21, P=0.006), but negatively correlated with Cur (r=-0.21, P=0.006), FEUA (r=-0.38, P<0.001), and age (r=-0.16, P=0.041). Meanwhile, FEUA was negatively correlated with SUA (r=-0.35, P<0.001) but not correlated with 24 hour urine volume, urine pH or glomerular filtration rate (GFR). 1 month after using urate-lowering therapy, SUA noticeably decreased (512.92 ± 139.64, 324.61 ± 123.27, P<0.001) and glomerular filtration rate (GFR) improved (110.50 ± 24.23, 160.82 ± 32.11, P<0.001).
Conclusion: For most patients with gout, hyperuricemia was caused by reduced renal excretion. FEUA and Cur were sensitive indicators of renal excretion of uric acid. Urate-lowering therapy is helpful for renal function improvement.
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