Limited Value of Uric Acid to Creatinine Ratios in Estimating Uric Acid Excretion

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Abstract
The value of the uric acid to creatinine ratio and the uric acid to creatinine clearance ratio in predicting 24 h urinary uric acid excretion was assessed in 49 patients with normal enzyme activity and 22 patients with purine enzyme deficiencies. A 24 h urinary uric acid to creatinine ratio > 0.75 was found in 6 of 9 patients with a partial deficiency of hypoxanthine-guanine phosphoribosyltransferase and in all patients with Lesch-Nyhan syndrome. A ratio of < 0.10 suggested xanthinuria or severe purine nucleoside phosphorylase deficiency. Neither ratio calculated from 2 h timed collections or the 24 h specimen showed a high correlation with 24 h urine uric acid excretion in patients with normal enzyme activity, perhaps because of a diurnal variation in urinary uric acid excretion. The spot-urine uric acid to creatinine ratio does not accurately predict the 24 h urine uric acid excretion in patients with normal enzyme activity.

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