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Hyperuricemia in pre-eclampsia. A reappraisal

H E Fadel, G Northrop, H R Misenhimer

    American Journal of Obstetrics and Gynecology
    |July 1, 1976
    PubMed
    Summary

    This study found that blood lactate levels are lower in pre-eclampsia and do not correlate with impaired uric acid clearance. Lactate infusion did not affect pre-eclamptic patients differently, questioning its role in pre-eclampsia etiology.

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    Area of Science:

    • Obstetrics and Gynecology
    • Nephrology
    • Biochemistry

    Background:

    • Pre-eclampsia (PE) is characterized by hyperuricemia and impaired uric acid clearance.
    • The potential role of blood lactate in the etiology of hyperuricemia in PE remains unclear.

    Purpose of the Study:

    • To investigate the relationship between blood lactate levels and hyperuricemia in pre-eclamptic, hypertensive, and normal pregnant women.
    • To determine if lactate influences uric acid clearance in these groups.

    Main Methods:

    • Measured serum and urinary uric acid, creatinine, lactate, and pyruvate in 17 PE, 22 hypertensive (H), and 13 normal pregnant (C) women.
    • Calculated uric acid clearance (Cur), creatinine clearance (Ccr), fractional uric acid clearance (Fract. Cur), and lactate/pyruvate (L/P) ratios.
    • Administered sodium lactate infusion to assess changes in parameters pre-, mid-, and post-infusion.

    Main Results:

    • Elevated serum uric acid and impaired Cur were observed in PE patients.
    • Blood lactate (L) levels were lower in PE compared to controls.
    • No correlation was found between L or L/P ratios and Cur.
    • Lactate infusion equally impaired Cur in all groups without significant inter-group differences in response.

    Conclusions:

    • The study casts doubt on the postulated role of blood lactate in the etiology of hyperuricemia in PE.
    • Contracted plasma volume and/or local angiotensin II release in the kidney are suggested as more significant factors in PE.

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