Enhanced renal clearance of uric acid in hepatic cirrhosis

Serum and urinary acid were measured in 10 patients with chronic hepatitis, in 22 patients with hepatic cirrhosis, and in 11 control subjects. Significant differences were found in urinary acid excretion, uric acid clearance, and uric acid:creatinine clearance ratio between patients with hepatic cirrhosis and control subjects. Two patients with hepatic cirrhosis were found to have hypouricemia. They showed a two- to threefold increase in uric acid clearance and in the uric acid:creatinine clearance ratio compared with control subjects, but their 24-h uric acid excretion was normal. In patients with hepatic cirrhosis, a significant negative correlation was found between plasma testosterone level and either uric acid clearance or uric acid:creatinine clearance ratio. These results indicate that uric acid clearance may be increased in patients with hepatic cirrhosis and that hypouricemia may result from a change in renal handling of uric acid. Moreover, changes in plasma testosterone levels may play an important part in affecting the renal handling of uric acid in these patients.