THE RENAL EXCRETION OF URIC ACID IN GOUT

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Abstract
Urate/inulin clearance ratios have been determined in 7 non gouty males before and after production of an increased urate load and in 16 gouty patients who were classified by the extent of their uric acid production. In all 5 gouty subjects who showed a normal production of uric acid there was a diminished urate/inulin clearance ratio. Among the patients who produced excessive amounts of uric acid there were individuals in whom the urate/ inulin clearance ratios were identical with those of normal control subjects in whom an excessive uric acid production was induced by dietary means. Other gouty patients were found in whom some degree of both overproduction and diminished renal excretion coexisted. The heterogeneous causes for hyperuricemia among gouty patients suggest a corresponding variety of basic metabolic defects to account for these manifestations.