Regulation of uric acid excretion by the kidney.

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Lipkowitz MS

Regulation of uric acid excretion by the kidney.

Curr Rheumatol Rep. 2012 Apr;14(2):179-88. doi: 10.1007/s11926-012-0240-z.

PubMed ID

22359229 [ View in PubMed

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Abstract

It has been known for many years that the kidney plays a major role in uric acid homeostasis, as more than 70% of urate excretion is renal. Furthermore, hyperuricemia in gout is most commonly the result of relative urate underexcretion, as the kidney has enormous capacity for urate reabsorption. A clear understanding of the mechanisms of renal handling of urate has been hampered by the differences between humans and animal models. The power of human genetics and genome-wide association studies has now provided new insight into the molecular mechanisms of urate transport by identifying the transporters that have critical roles in urate transport. This review surveys the new evidence for a molecular model of urate transport in the renal proximal tubule and uses these data to refute the popular four-component model for urate transport that has long been in vogue. It also discusses data that help us understand the relation of diuretics to hyperuricemia, losartan-induced uricosuria, variations in uric acid levels in hyperglycemia, and the effects of dairy diets on serum urate levels. In the end, several of these clinical findings are explained, and the remaining gaps in our knowledge will become evident.

DrugBank Data that Cites this Article

Drug Transporters

Drug	Transporter	Kind	Organism	Pharmacological Action	Actions
Losartan	Solute carrier family 2, facilitated glucose transporter member 9	Protein	Humans	Unknown	Inhibitor	Details
Losartan	Solute carrier family 22 member 12	Protein	Humans	Unknown	Inhibitor	Details