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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As shown in Table 4benzbromarone did not change renal excretion of urate in these two groups.

Uricosuric effect of losartan in patients with renal transplants.

Effect of the angiotensin II receptor antagonist losartan on uric acid and oxypurine metabolism in healthy subjects. As urate levels increase, individuals are at a greater risk for saturation and formation of crystals. Comorbidities of gout and hyperuricemia in the US general population: Zanchetti A, Mancia G. Related articles in Web of Science Google Scholar. Uricosuriv were no statistical differences in the pre- and postadministration values between the two groups.

ARBs inhibit the activity of angiotensin II, a potent vasoconstrictor that is formed through a conversion from angiotensin I by angiotensin-converting enzyme ACE [ Michel et al. In general, this effect is achieved by action on the proximal tubule of the kidney.

NR Khan et al. Rayner and colleagues conducted an open-label, randomized, controlled, two-parallel group study [ Rayner et al. Individuals with secondary hypertension, significant cardiac history including MI within the past year, and transient ischemic attack TIA or cerebrovascular attack CVA within the past 3 years were excluded. Sign In or Create an Account. From baseline, fenofibrate reduced serum uric acid levels from 7.

It may also be necessary to conduct additional studies for longer periods of time to capture this clinical outcome.

ARB clinical trials around the turn of the millennium. While utilized for uricosugic indications, the available ARBs differ widely in their chemical structures, which correlate to various differences in their pharmacodynamic and pharmacokinetic effects.


Effect of losartan and benzbromarone on renal excretion of urate in hypouricemic hypertensive patients carrying the mutant URAT1 gene. The URAT1 inhibitor did not modify urate excretion in the URAT1-deficient patients with or without impaired renal function, indicating impaired renal function associated with idiopathic renal hypouricemia did not affect the results of the URAT1 inhibitor uriclsuric test.

Uticosuric serum urate levels are also controlled by the uricosuroc 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. Antiuricosuric drugs raise serum uric acid levels and lower urine uric acid levels. Thus, use of these drugs is contraindicated in persons already with a high urine concentration of uric acid hyperuricosuria.

Taken together, these findings show that the effects of losadtan angiotensin receptor blockers on urate excretion are not influenced by renal adaptation. In the losartan monotherapy group, uric acid levels decreased from 8.

Future studies are needed with additional ARBs and with losartan evaluating endpoints such as prevention of gout attacks or gout-related hospitalizations. The impact of serum uric acid on cardiovascular outcomes in the LIFE study. URAT1 serves as a urate—anion exchanger in the proximal tubule of the kidney and is a key target for uricosuric agents [ Choi et al. Idiopathic renal hypouricemia is an inherited and heterogeneous disorder characterized by impaired tubular urate transport.

Uricosuric effect of losartan in patients with renal transplants.

Two-way analysis of variance with repeated measures was performed to analyze the effects of losartan and candesartan. Losartan appears to be a safe and efficacious agent to lower serum uric acid levels in patients with hyperuricemia.

Angiotensin II is a vital regulator of homeostasis and is a primary component of the renin-angiotensin system. In addition, it is estimated that employed individuals diagnosed with gout miss 5 days more per year than their counterparts without the disease. Gout and its comorbidities. A total of eight studies met the inclusion criteria.

Renal clearance for urate Cur and creatinine Ccr was determined as described elsewhere. Recent developments, and where do they leave us?


The effect of angiotensin II receptor blockers on hyperuricemia

This makes it difficult to extrapolate the longer potential effects on serum uric acid with losartan use. In the hydrochlorothiazide monotherapy group, uric acid levels increased from 8. National Center for Biotechnology InformationU. Upon review of the three studies which looked at the uricosuric effects of candesartan and irbesartan, there was no significant benefit with use of these agents [ Dang et al. Bull Hosp Jt Dis While losartan demonstrated statistical significance in improving these surrogate endpoints, it is hard to correlate this to clinical significance.

Ann Rheum Dis In three of the studies incorporated in this review, the addition of losartan was beneficial in offsetting the rise of uric acid levels in the setting of hydrochlorothiazide use [ Shahinfar et al. Related articles Gout hypertension losartan uric acid valsartan. The lack of effect of URAT1 inhibitors on renal excretion of urate was independent of the renal function of hypouricemic patients. Receive exclusive offers and updates from Oxford Academic.

Losartan showed a slightly higher hypotensive effect than valsartan in patients newly diagnosed with gout. J Cardiovasc Pharmacol A placebo-controlled, forced titration study. However, it is still unknown whether the inhibitory effect of losartan on URAT1 contributes to its uricosuric action in humans. None of them had gout or urinary calculi, or were they under treatment with oral antidiabetic agents, nonsteroidal anti-inflammatory drugs or fibrates.

Loss-of-function mutations of URAT1 cause idiopathic renal hypouricemia due to high urinary urate excretion. However, only two of the studies evaluated the use of losartan in combination with hydrochlorothiazide in those with elevated blood pressure at baseline, and it was found to have a beneficial effect on blood pressure lowering in these patients [ Shahinfar uricsouric al.

From Wikipedia, the free encyclopedia. Excess urate excretion correlates with severely acidic urine in patients with renal hypouricemia.

A novel type uricosric renal hypouricemia.