Transplantation. Jul 27;66(2) Uricosuric effect of the angiotensin II receptor antagonist losartan in heart transplant recipients. Minghelli G(1). This agent promotes uric acid excretion via effects on the organic anion transport The AIIA losartan also produces a uricosuric effect in healthy volunteers. Uricosuric medications (drugs) are substances that increase the excretion of uric acid in the urine, thus reducing the concentration of uric acid in blood plasma. In general, this effect is achieved by action on the proximal tubule of the the uricosurics benzbromarone and losartan had no effect, suggesting these drugs act.
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Exercise-induced acute renal failure and nephrolithiasis have been reported as complications of hypouricemia. This is the first evidence that loss-of-function of URAT1 abolished the urate-lowering effect induced by losartan in humans.
Arthritis Care Res In the hydrochlorothiazide monotherapy group, uric acid levels increased from 8.
Because changes in renal excretion of urate induced by angiotensin receptor blockers might be influenced by renal adaptation during their administration, we reexamined the acute effects of candesartan before and 2 h after its administration on renal excretion of urate. In conclusion, we demonstrated that the uricosuric action of losartan was abolished in hypertensive patients who carried loss-of-function mutations in the URAT1 gene, while in hypertensive patients harboring the wild-type URAT1 gene losartan induced uricosuria, indicating that URAT1 is responsible for the uricosuric action of losartan in humans.
Effect of eposartan and losartan on uric acid metabolism in patients with essential hypertension. Therefore ARBs play a significant role in the treatment of hypertension and as renoprotective agents [ Michel et al. The URAT1 inhibitor did not modify urate excretion in the URAT1-deficient patients with or edfect impaired renal function, indicating impaired renal function associated with idiopathic renal hypouricemia did not affect the results of the URAT1 effcet loading test.
The authors declare no conflicts of interest in preparing this article. Study participants were excluded if they had a diagnosis of gout or renal lithiasis within the last 2 years. J Hum Hypertens ; Those with baseline use of steroids, NSAIDs, allopurinol, colchicine or with renal dysfunction were excluded. Changes in biochemical parameters at the end of each stage of the study Click here to view.
Two-way analysis of variance with repeated measures was performed to analyze the effects of losartan and candesartan.
Status of endothelial dependent vasodilation in patients with hyperuricemia. Uric acid as uriosuric cardiovascular risk factor in arterial hypertension. Changes in lab values such as elevations in serum creatinine and potassium were noted; however, these results were deemed clinically insignificant as they remained within normal limits [ Dang et al.
It furthers the University’s objective of excellence in research, scholarship, and education urciosuric publishing worldwide. There was no safety analysis conducted in this study [ Khan et al. J Renin Angiotensin Aldosterone Syst ; Finally, when there is dysfunction of the urate transporter ABCG2, it has been found that there is the potential for both renal underexcretion of uric acid and a blockade of intestinal urate excretion, thereby leading to renal urate overload [ Matsuo et al.
Ann Intern Med Citing articles via Web of Science Several gout attacks occurred through each phase of the study.
Uricosuric – Wikipedia
In this regard, we had previously reported that losartan significantly increased urate excretion 2 h after its administration, 4 and that the increase was similar after 1 month of treatment.
Despite the reduction in serum uric acid levels and increased excretion of uric acid from losartan therapy as evidenced by the studies reviewed, it would be beneficial to explore more clinically meaningful endpoints in the future, such as reduction in the number of gout attacks or hospitalizations associated with gout.
Mutation analysis of URAT1 and clearance study of hypertensive patients with idiopathic renal hypouricemia.
The angiotensin receptor blocker losartan inhibited urate transporter 1 URAT1 according to in vitro experiments. Conflict of interest statement: Pilot study of the uricosuric effect of DuP, a new angiotensin II receptor antagonist, in healthy subjects.
We demonstrated that candesartan urkcosuric not increase urate excretion 2 h after its administration, or after 1 month of treatment. Probenecid Sulfinpyrazone Benzbromarone Isobromindione. The effect of ARBs on the occurrence of gout attacks or other clinical outcomes were not represented.
Uricosuric effect of losartan in patients with renal transplants.
There are differences in the chemical structures of the ARBs, there is potential for the ARB to be cis -inhibitory or trans -stimulating or both, and there is variability uircosuric ARBs to have inhibitory effects on the uptake of uric acid by the URAT1 receptor [ Iwanaga et al.
WolffJennifer L. Gout and its comorbidities. Furthermore, evaluating quality of life and gout attack free intervals would help quantify the relevance of incorporating losartan with xanthine oxidase inhibitors for gout management. The renal-specific transporter mediates facilitative transport of organic anions at the brush border membrane of mouse renal tubules.
Ther Adv Chronic Dis. Many medication therapies have secondary uricosuric effects, and although used for alternate primary indications, can assist conventional agents in reducing serum uric acid levels. This adverse effect was not expected, although this raises an important concern with chronically elevated serum uric acid levels precipitating gout attacks.
Shahinfar and colleagues conducted a double-blind, placebo-controlled, parallel study with 63 patients to explore the safety and efficacy of losartan in individuals with thiazide-induced hyperuricemia [ Shahinfar et al. The angiotensin II receptor blocker losartan lowers serum concentration of urate Sur in hypertensive subjects through a significant uricosuric action. As urate levels increase, individuals are at a greater risk for saturation and formation of crystals.
J Pharmacol Exp Ther Renal clearance study to determine Cur and Ccr was performed as described elsewhere. Losartan appears to be a safe and efficacious agent to lower serum uric acid levels in patients with hyperuricemia.
However, the increased uric acid levels in urine can contribute to kidney stones.
Uricosuric effect of losartan in patients with renal transplants.
Candesartan and irbesartan were the other ARBs found in the literature that were compared to losartan for their potential uricosuric effects. Although serum urate levels are losadtan controlled by the production of uric acid in the liver, losartan and its active metabolite E have been reported to exert no inhibitory effects on the xanthine oxidase activity in an in vitro experiment.
Although these drugs may have losarran uricosuric action, their other significant pharmacological actions in off-label use as a uricosuric requires careful assessment of the patient to achieve the most benefit and least risk.