Impairment of urate excretion in patients with cardiac disease
S. E. Mace, A. J. Newman and J. Liebman
The serum uric acid levels and uric acid clearance rates were evaluated in
28 patients who had congenital heart disease. Based on hemodynamic
assessments, the patients were divided into three groups: group 1, with
normal cardiac output and normal arterial oxygen saturation; group 2, with
hypoxemia (normal cardiac output with a decreased arterial oxygen
saturation); and group 3, with cardiomyopathy (decreased cardiac output).
The blood levels of uric acid were elevated in group 3. The mean serum uric
acid levels were as follows: group 1, 4.2 mg/dL; group 2, 4.8 mg/dL; and
group 3, 11.7 mg/dL. All the patients in groups 2 and 3 had decreased uric
acid clearance rates. The mean uric acid clearance rates were as follows:
group 1, 10.1 mL/min/sq m; group 2, 4.2 mL/min/sq m; and group 3, 1.7
mL/min/sq m. The patients in group 3 had the most severe abnormalities.
Patients with congenital heart disease may have marked impairment of their
uric acid excretion, which can occur in the absence of significant renal
disease, and may be found in acyanotic as well as cyanotic patients.
