Transplantation. Jul 27;66(2) Uricosuric effect of the angiotensin II receptor antagonist losartan in heart transplant recipients. Minghelli G(1). This agent promotes uric acid excretion via effects on the organic anion transport The AIIA losartan also produces a uricosuric effect in healthy volunteers. Uricosuric medications (drugs) are substances that increase the excretion of uric acid in the urine, thus reducing the concentration of uric acid in blood plasma. In general, this effect is achieved by action on the proximal tubule of the the uricosurics benzbromarone and losartan had no effect, suggesting these drugs act.

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Furthermore, all of the studies looked only at surrogate endpoints including serum uric acid levels and fractional excretion of uric acid and did not further explore clinical outcomes. A novel type of renal hypouricemia. Clinic BP was measured using a mercury sphygmomanometer and a uricosiric of appropriate size in accordance with the American Heart Association Committee on Blood Pressure Determination.

The effect of angiotensin II receptor blockers on hyperuricemia

View large Download slide. We demonstrated that candesartan did not increase urate excretion 2 h after its administration, or after 1 month of treatment. Urine samples were collected from 8: Lipid exchange at ER-mitochondria contact sites: Renal handling of uric acid in normal and gouty subject: Idiopathic renal hypouricemia is an inherited and heterogeneous disorder characterized by impaired tubular urate transport.

The phase before the administration of the drug consisted of a single-clearance period of 30 min.

In contrast, genetic mutations in GLUT9 can precipitate individuals to a defect in uric acid absorption leading to hypouricemia [ Dinour et al. Am J Hypertens ; Those with baseline use of steroids, NSAIDs, allopurinol, colchicine or with renal dysfunction were excluded. A follow-up study was conducted by the same study investigators which evaluated an additional outcome of urinary acid excretion [ Khan et al.


Finally, when there is dysfunction of the urate transporter ABCG2, it has been found that there is the potential for both renal underexcretion of uric acid and a blockade of intestinal urate excretion, thereby leading to renal urate overload [ Matsuo et al. Effect of benzbromarone on renal excretion of urate in URAT1-deficient hypouricemic patients distributed into those with normal Ccr and those with impaired Ccr.

Pak J Pharm Sci Although these drugs may have significant uricosuric action, their other significant pharmacological actions in off-label use as a uricosuric requires careful assessment of the patient to achieve the most benefit and least risk. J Am Soc Nephrol ;9: Individuals with secondary hypertension, significant cardiac history including MI within the past year, and transient ischemic attack TIA or cerebrovascular attack CVA within the past 3 years were excluded.

This represented an additional Before and after 1-month treatment, the serum concentration of urate Sur and creatinine Scrand the clearance value of effecg Cur and creatinine Ccr were determined.

From Wikipedia, the free encyclopedia. Clinical and molecular analysis of patients with renal hypouricemia in Japan—influence of URAT1 gene on urinary urate excretion. Newer agents such as pegloticase have also emerged in treatment guidelines, but the use of these agents is only recommended in severe gout when oral agents have failed [ Khanna et al.

URAT1 is the central mediator in the transport of uric acid from the kidney into the blood. These findings suggested that losartan inhibited URAT1 and thereby it lowered Sur levels in hypertensive patients.

Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. In addition, combination therapy with losartan, increased the fractional excretion of uric acid from 6.

No studies reviewed the incidence of gout attacks during the prespecified time [ Rayner et al. Mutation analysis of URAT1 and clearance study of hypertensive patients with idiopathic renal hypouricemia.

Patients and clearance study in hypertensive patients. As shown in Table 4benzbromarone did not change renal excretion of urate in these two groups. In this study, we first confirmed the uricosuric action of losartan in hypertensive patients in comparison with candesartan. Am J Med Uricosuric medications drugs are substances that increase the excretion of uric acid in the urinethus reducing the concentration of uric acid in effeft plasma. Potassium and serum creatinine levels were reviewed and lsoartan lab values remained within accepted normal ranges throughout the study [ Dang et al.


From baseline, fenofibrate reduced serum uric acid levels from 7. Related articles in Web of Science Google Scholar. Open in a separate window.

In some persons with loss-of-function mutations of URAT1, the uricosurics benzbromarone and losartan had no effect, suggesting these drugs act on URAT1 in vivo. Changes in biochemical parameters at the end of urixosuric stage of the study Click here to view. A tribute to Scipione Riva-Rocci.

Asymptomatic hyperuricemia can occur and, treatment with urate-lowering therapy most commonly occurs only in high risk patients such as those with a history of multiple gout attacks [ Khanna et al.

The effect of angiotensin II receptor blockers on hyperuricemia

Furthermore, ruicosuric quality of life and gout attack free intervals would help quantify the relevance of incorporating losartan with xanthine oxidase inhibitors for gout management. Gout and its comorbidities. We demonstrated that losartan at a clinical dose level failed to induce uricosuria in URAT1-deficient hypouricemia patients.

As urate levels increase, individuals are at a greater risk for saturation and formation of crystals. Pilot study of the uricosuric effect of DuP, a new effeft II receptor antagonist, in healthy subjects.

Discussion This review explored the available literature for the urate-lowering effects of ARBs. Thus, we postulate that losartan induces a particularly brisk response of BP regardless of Sur values.