Abstract
Investigation of the genetic basis of hyperuricaemia is a subject of intense interest. However, clinical studies commonly include hyperuricaemic patients without distinguishing between 'over-producers' or 'under-excretors' of urate. The statistical power of studies of genetic polymorphisms of genes encoding renal urate transporters is diluted if 'over-producers' of uric acid are included. We propose that lower than normal fractional renal clearance of urate is a better inclusion criterion for these studies. We also propose that a single daytime spot urine sample for calculation of fractional renal clearance of urate should be preferred to calculation from 24-hour urine collections.
Highlights
Investigation of the genetic basis of hyperuricaemia is a subject of intense interest
We suggest that renal uric acid clearance be normalised to the individual’s glomerular filtration rate (GFR), as estimated by the creatinine clearance, to give the fractional clearance of urate (FCU)
We propose that FCU calculated from spot urine samples be used as the inclusion criterion in studies examining the genetic basis for relatively low renal clearance of urate
Summary
Investigation of the genetic basis of hyperuricaemia is a subject of intense interest. We propose that FCU calculated from spot urine samples be used as the inclusion criterion in studies examining the genetic basis for relatively low renal clearance of urate. A renal lesion(s) that reduces the ability of the kidney to clear uric acid, but not creatinine, will manifest as a low FCU relative to normal.
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