In diabetic patients, hyperglycemia causing uricosuria
along with polyuria reduce uric acid concentrations and decrease gout attacks; conversely, the gout episodes may increase with less glycosuria when blood glucose is reduced with treatment (37).
Fanconi syndrome caused by TDF is characterized by generalized proximal tubular dysfunction resulting in one or more of the following: bicarbonaturia, glucosuria, phosphaturia, uricosuria
, aminoaciduria, and tubular proteinuria.
It is characterized by proximal tubular dysfunction and 30-80% of patients can progress to chronic kidney disease or renal failure: low molecular weight proteinuria, hypercalciuria, glycosuria, phosphaturia, aminoaciduria, uricosuria
, hematuria and nephrocalcinosis (140,141,142).
We analyzed the following variables: age, BMI (body mass index, kg/m2), creatinine serum (mg/dL), calcium serum (mg/dL), phosphorus serum (mg/dL), phosphatase alkaline serum (U/L), iPTH (intact parathyroid hormone, pg/mL), 25-OH vitamin D (U/L), pH serum, urine pH, 24-hour urine calcium, 24-hour citraturia, 24-hour oxaluria, 24-hour uricosuria
, and calcium/creatinine ratio in urine during fasting.
High doses of vitamin C have been claimed to cause oxalate excretion, kidney stones, uricosuria
, vitamin B12 deficiency, systemic conditioning, and pro-oxidant effects.
Stein, et al., "Ascorbic Acid-Induced Uricosuria
: A Consequence of Megavitamin Therapy," Ann.
They may also have nonnephrotic-range proteinuria, uricosuria
and, at times, renal tubular acidosis.
(7) Although the mechanism for protein-mediated urate excretion had not been determined, at least one investigator has suggested that it may be the action of amino acids rather than intact protein, competing as weak acids at renal urate transporters, that acts to block urate uptake and induce uricosuria
. 8 Whether dairy intake could have a urate-lowering action in patients with significant renal insufficiency has not been tested, but would seem to be unlikely under the current model.
* The need to prevent malignancy-related hyperuricemia and tumor lysis syndrome due to cytolytic therapy for hematologic malignancies, with massive uricosuria
precluding the use of uricosuric drugs.