A simple method of selecting gout patients for treatment with uricosuric agents, using spot urine and blood samples.

Abstract

OBJECTIVE:

To develop a simple means of selecting gout patients for treatment with uricosuric agents.

METHODS:

In 124 gout patients, spot urine and blood were sampled before breakfast and after overnight fast (except water) on the day of 24 h urine collection. Spot urine uric acid/creatinine ratio (Ua/Cr mmol/mmol) and serum creatinine x Ua/Cr (Scr*Ua/Cr micromol/l) were calculated together with 24 h urinary uric acid excretion/body surface (24 Ua/S). The patients were then classified either below or above 2.84 mmol/m2/day for 24 Ua/S.

RESULTS:

Classifications based on spot urine Ua/Cr (cut off value set at 0.34), spot urine Scr*Ua/Cr (cut off value set at 28.1), and a combination of spot urine Ua/Cr and Scr*Ua/Cr were found to be not significantly different in diagnostic accuracy for the detection of patients with 24 Ua/S below 2.84 mmol/m2 (77%, 81%, and 81%, respectively) and sensitivity (80%, 83%, and 76%, respectively). However, specificity by a combination of spot urine Ua/Cr, and spot urine Scr*Ua/Cr was higher than by spot urine Ua/Cr alone (91% vs 74%, P < 0.05), although the specificity was not significantly different between a combination and spot urine Scr*Ua/Cr alone (91% vs 78%) or between spot urine Ua/Cr and spot urine Scr*Ua/Cr (74% vs 78%).

CONCLUSION:

A combination of spot urine Ua/Cr and spot urine Scr*Ua/Cr may be clinically useful in selecting gout patients with 24 Ua/S below 2.84 mmol/m2 for treatment with uricosuric agents without adverse effects.

• Authors: Tetsuya Yamamoto, Yuji Moriwaki, Sumio Takahashi, Zenta Tsutsumi, Tuneyoshhi Ka, Minoru Fukuchi, Toshikazu Hada
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 29 Issue 9 Pg. 1937-41 (Sep 2002) ISSN: 0315-162X [Print] Canada
• PMID: 12233889 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Uricosuric Agents
• Uric Acid

Topics

• Adult
• Analysis of Variance
• Blood Chemical Analysis
• Case-Control Studies
• Chi-Square Distribution
• Gout (diagnosis, drug therapy)
• Humans
• Male
• Middle Aged
• Patient Selection
• Reference Values
• Sampling Studies
• Sensitivity and Specificity
• Severity of Illness Index
• Specimen Handling
• Uric Acid (blood)
• Uricosuric Agents (therapeutic use)
• Urinalysis