Maintenance of normouricaemia during adolescence in sickle-cell anaemia

Aspects of uric acid metabolism were investigated during adolescence in 122 patients with sickle-cell anaemia in the steady state and 52 matched controls with normal haemoglobin AA. Plasma urate concentrations were significantly lower (P less than 0.02) in male patients than in male controls. No significant differences were observed between either female patients and female controls or total patient group and total control group. Further study in subgroups of the subjects showed that all indices of urinary urate excretion in male patients were significantly increased over male controls or female patients. The increases in these indices in female patients over female controls were not statistically significant. Significant inverse correlations were also found between plasma urate and either renal urate clearance (r = -0.483, P less than 0.02) or fractional urate excretion (r = -0.398, P less than 0.05) in the patients. These findings indicate that patients with sickle-cell anaemia maintain normouricaemia during adolescence by increasing renal urate disposal. This process appears to be more efficient in the male patients.