Alteration of Urate Metabolism by Weight Reduction

Summary: Urate kinetics within the body were defined on two occasions in a patient with gout. On the first occasion, he was obese and urate metabolism was abnormal, whereas on the second occasion, after 18 kilogrammes weight loss, urate metabolism was within the normal range. This alteration was due to two changes, firstly, a rise in the renal clearance of urate without change in glomerular filtration rate, possibly related to an associated fall of his previously elevated blood pressure to normal, and secondly, a reduction in the rate of urate production from a high initial level to one within the normal range. This study emphasises the importance of acquired factors in the development of gout and that correction of these may obviate the need for pro-longed drug therapy.