Hypouricemia due to renal tubular defect. A study with the probenecid-pyrazinamide test

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Abstract
Hypouricemia with hyperuricosuria due to isolated renal tubular defects are rare conditions. Two patients with hypouricemia and hyperuricosuria were studied for derangements in the renal urate transport with the combined probenecid-pyrazinamide test. In the 1st patient a significant decrease (64.5%) in the urate clearance-creatinine clearance ratio was noted after pyrazinamide administration, suggesting a postsecretory urate reabsorption defect, whereas the significant rise (44.2%) in urate clearance after the administration of probenecid indicates that this defect may not be complete. In the 2nd patient there was a rise of 96.9% in the urate clearance-creatinine clearance ratio after the administration of probenecid and a decline of 31.6% in that ratio after pyrazinamide. A defect was suggested in the presecretory reabsorptive site, with a highly significant response most probably of the postsecretory reabsorptive site to probenecid.