NOCTURNAL INCREASE OF URINARY URIC-ACID - CREATININE RATIO - A BIOCHEMICAL CORRELATE OF SLEEP-ASSOCIATED HYPOXEMIA

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Abstract
Sleep-associated hypoxemia may result in tissue hypoxia and increased production and excretion of adenosine triphosphate (ATP) degradation intermediates and uric acid. Urinary uric acid:creatinine (UA:Cr) ratio is a convenient method for estimating uric acid excretion. We measured the overnight changes in urinary UA:Cr ratio in 17 patients with documented sleep-associated hypoxemia, 13 control patients who remained normoxemic during polysomnography, and 14 normal volunteers. The urinary UA:Cr ratio increased overnight in patients with sleep-associated hypoxemia (+ 312 .+-. 10.9%), whereas it decreased in the control patients with negative sleep studies (-13.6 .+-. 4.6%; p .ltoreq. 0.01) and in the normal volunteers (-23.2 .+-. 5.8%). Repeat polysomnography revealed interval resolution of sleep-associated hypoxemia in 2 patients and significant improvement in a third. In every case, this clinical improvement was accompanied by a decrease in the overnight change in UA:Cr ratio. We report that urinary UA:Cr ratio increased overnight in a nonhomogeneous group of patients with sleep-associated hypoxemia.

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