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Glomerular function and hyperuricaemia in sickle cell disease.

A G Morgan, K De Ceulaer, G R Serjeant

    Journal of Clinical Pathology
    |September 1, 1984
    PubMed
    Summary
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    In sickle cell disease patients, serum urate levels are linked to kidney function, specifically creatinine clearance. High single nephron filtration rates may explain abnormal urate handling in these individuals.

    Area of Science:

    • Nephrology
    • Hematology
    • Metabolic Disorders

    Background:

    • Renal insufficiency is prevalent in adults with homozygous sickle cell disease (SCD).
    • Hyperuricemia is a common feature in SCD patients, but its cause is not fully understood.
    • The role of glomerular and tubular function in SCD-related hyperuricemia requires clarification.

    Purpose of the Study:

    • To investigate the contribution of glomerular failure to hyperuricemia in adults with homozygous sickle cell disease.
    • To determine the relationship between serum urate concentration, glomerular filtration, and tubular function in SCD patients.

    Main Methods:

    • A study involving 64 adult patients (ages 15-66) with homozygous sickle cell disease.
    • Measurement of serum urate concentration, creatinine clearance, and assessment of tubular proteinuria.

    Related Experiment Videos

  • Analysis of the correlation between serum urate and renal urate clearance parameters.

    • Main Results:

    • Serum urate concentration was dependent on both renal urate clearance and creatinine clearance.
    • An abnormal relationship between serum urate and creatinine clearance was observed in SCD patients.
    • Increased urate excretion per unit of glomerular filtrate and fractional excretion of urate were noted with decreasing creatinine clearance.
    • Patients with tubular disease (tubular proteinuria) did not exhibit significantly different serum urate levels compared to non-proteinuric controls.

    Conclusions:

    • High single nephron glomerular filtration rates may contribute to abnormal urate handling in SCD.
    • The tubular secretion of urate appears to be preserved, even with declining renal function.
    • Previous assumptions linking renal tubular disease directly to hyperuricemia in SCD may need reevaluation based on these findings.