Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Jun;18(6):34.
doi: 10.1007/s11926-016-0587-7.

Urate Handling in the Human Body

David Hyndman  1 , Sha Liu  2 , Jeffrey N Miner  2
Affiliations
Review

Urate Handling in the Human Body

David Hyndman et al. Curr Rheumatol Rep. 2016 Jun.

Abstract

Elevated serum urate concentration is the primary cause of gout. Understanding the processes that affect serum urate concentration is important for understanding the etiology of gout and thereby understanding treatment. Urate handing in the human body is a complex system including three major processes: production, renal elimination, and intestinal elimination. A change in any one of these can affect both the steady-state serum urate concentration as well as other urate processes. The remarkable complexity underlying urate regulation and its maintenance at high levels in humans suggests that this molecule could potentially play an interesting role other than as a mere waste product to be eliminated as rapidly as possible.

Keywords: Excretion; FEUA; Gout; Urate; Uric acid.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Holding intestinal clearance constant at 6 ml/min, production constant at 1100 mg/day, and GFR constant at 100 mL/min, sUA is calculated as production divided by total clearance (extra-renal plus renal clearance)
Fig. 2
Fig. 2
Urate transporters in the kidney—a representative proximal tubule cell is shown with the relevant secretory and resorptive transporters localized to either the basolateral or apical membranes. The arrows denote the direction of transport for substrates. The question marks for urate and selected transporters denote that questions surround the role of these proteins in urate handling in vivo
Fig. 3
Fig. 3
Representation of our view on the effects of changing sUA on FEUA. This is based on our own clinical analysis as well as data from several publications that have reported that FEUA increases as sUA is increased by purine loading or urate infusion. Also, FEUA has been seen to decrease when sUA is decreased by xanthine oxidase inhibitors or low purine diets but does not go below FEUA of 2 % and apparently levels off as sUA approaches zero [, , , , –52]
See this image and copyright information in PMC

References

    1. Wang Z, Königsberger E. Solubility equilibria in the uric acid-sodium urate-water system. Thermochim Acta. 1998;310:237–42. doi: 10.1016/S0040-6031(97)00230-X. - DOI
    1. Choi HK, Mount DB, Reginato AM. Pathogenesis of gout. Ann Intern Med. 2005;143(7):499–516. doi: 10.7326/0003-4819-143-7-200510040-00009. - DOI - PubMed
    1. Zhang W, Doherty M, Bardin T, Pascual E, Barskova V, Conaghan P, et al. EULAR evidence based recommendations for gout, part II: management: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) Ann Rheum Dis. 2006;65(10):1312–24. doi: 10.1136/ard.2006.055269. - DOI - PMC - PubMed
    1. Khanna D, Fitzgerald JD, Khanna PP, Bae S, Singh MK, Neogi T, et al. 2012 American College of Rheumatology guidelines for management of gout, part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res. 2012;64(10):1431–46. doi: 10.1002/acr.21772. - DOI - PMC - PubMed
    1. Oh JH, Dossetor JB, Beck IT. Kinetics of uric acid transport and its production in rat small intestine. Can J Physiol Pharmacol. 1967;45(1):121–7. doi: 10.1139/y67-013. - DOI - PubMed