Effect of a Reduction in Uric Acid on Renal Outcomes During Losartan Treatment: A Post Hoc Analysis of the Reduction of End Points in Noninsulin-Dependent Diabetes Mellitus With the Angiotensin II Antagonist Losartan Trial

Abstract

To the Editor: We read with interest the recent article by Miao et al,1 which presents the results of a post hoc analysis of the Reduction of Endpoints in Non-Insulin-Dependent Diabetes Mellitus With the Angiotensin II Antagonist Losartan Study. The results suggest that losartan reduces serum uric acid (sUA), and this relates to the degree of long-term renal risk reduction and explains part of losartan's renoprotective effect. We raise some issues. sUA remained at its baseline of 6.7 mg/dL after losartan treatment. Because the placebo arm showed a rise in sUA (6.7–6.9 mg/dL), there was a mean group difference in sUA of …