[Uric acid metabolism in children with hyperuricosuria]

We treated 39 children with hyperuricosuria (18 boys and 21 girls aged between 6 and 11 years). Treatment consisted of increased fluid intake, low salt and low purine diet and urine alkalization up to pH 6.5-6.8. We have selected two groups of patients with different uric acid [UA] metabolism parameters. In group I (21 children) mean value of serum UA was 2.52 mg/dL, mean urine UA excretion was 13.11 mg/kg/d and UA FE was 21.51%. In group II (18 children) mean value of serum UA was 4.7 mg/dL, mean urine UA excretion was 12.8 mg/kg/d and UA FE was 10.9%. In group I, treatment did not normalize uricosuria (13.57 mg/kg/d), urine pH was elevated (6.56). In group II uricosuria was diminished (8.37 mg/kg/d), urine pH was 6.37. 1. Disturbances of tubular secretion may be suspected in some children with hyperuricosuria and without hypouricemia. 2. The maintenance of urine pH within normal values is the basic of treatment in children with hyperuricosuria. 3. In children suspected of tubular transport disturbances appropriate tests of uric acid metabolism should be performed.