Observations of serum uric acid levels in 22 male cirrhotics showed that the mean concentration of serum urate was 4.18 ± 0.25, significantly lower than that found in 22 age-matched, male controls, 6.44 ± 0.19 (P<.001). Twenty-four-hour urate excretion measured in ten patients from each group with mean serum uric acid levels similar to those of the parent group were not significantly different. Further study in three patients disclosed that the ratio of urate clearance to creatinine clearance was increased, and data obtained after the administration of pyrazinamide suggested that this increase resulted from impaired tubular urate reabsorption. Finally, data comparing serum bilirubin levels and serum urate concentration showed that the two were inversely related in a statistically significant manner (P<.001).
Michelis MF, Warms PC, Fusco RD, Davis BB. Hypouricemia and Hyperuricosuria in Laennec Cirrhosis. Arch Intern Med. 1974;134(4):681–683. doi:10.1001/archinte.1974.00320220083009
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