Vol 1, No 1 (1997)
Original paper
Published online: 2000-02-10
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Effect of hydrochlorothiazide and indapamide on renal handling of uric acid in patients with essential hypertension

Andrzej Tykarski, Anna Posadzy-Małaczyńska, Paweł Łopatka, Jerzy Głuszek, Danuta Musialik, Bożena Raszeja-Wanic
Nadciśnienie tętnicze 1997;1(1):6-10.
Vol 1, No 1 (1997)
Prace oryginalne
Published online: 2000-02-10

Abstract


Background High serum uric acid is a frequent finding in patients with essential hypertension, It is partly caused by antihypertensive therapy. Thiazides diminish renal excretion of uric acid and increase the incidence of hyperuricemia. Indapamide, thiazide-like diuretic has diiferent metabolic profile but little is known about its effect on uric acid excretion. The aim of the study was to compare the effect of hydrochlorothiazide and indapamide on plasma uric acid and tubular transport of urate in nephron in hypertensive patients.
Methods Thirty six patients with mild to moderate essential hypertension were studied. Twenty of them received hydrochlorothiazide in dose 25 mg/day and sixteen were treated with indapamide in dose 2,5 mg/day as monotherapy. Patients were kept on normal sodium and purine diet. Plasma uric acid (Pua) was measured and pharmacological tests with pirazynamide and benzbromarone were performed before and after 3 to 5 weeks of diuretic treatment. Based on these tests uric acid clearance and fractional excretion as well as presecretory reabsorption, tubular secretion and postsecretory reabsorption of uric acid were calculated.
Results and conclusions Hydrochlorothiazide increases plasma uric acid and decreases its renal excretion in hypertensive patients. Both diminished tubular secretion and accelerated postsecretory reabsorption of uric acid are responsible for hypcruricaemic action of hydrochlorothiazide. Indapamide does not change neither plasma uric acid nor its renal handling. It seems that in patients with essential hypertension and gout indapamide is the diuretic of choice.

Abstract


Background High serum uric acid is a frequent finding in patients with essential hypertension, It is partly caused by antihypertensive therapy. Thiazides diminish renal excretion of uric acid and increase the incidence of hyperuricemia. Indapamide, thiazide-like diuretic has diiferent metabolic profile but little is known about its effect on uric acid excretion. The aim of the study was to compare the effect of hydrochlorothiazide and indapamide on plasma uric acid and tubular transport of urate in nephron in hypertensive patients.
Methods Thirty six patients with mild to moderate essential hypertension were studied. Twenty of them received hydrochlorothiazide in dose 25 mg/day and sixteen were treated with indapamide in dose 2,5 mg/day as monotherapy. Patients were kept on normal sodium and purine diet. Plasma uric acid (Pua) was measured and pharmacological tests with pirazynamide and benzbromarone were performed before and after 3 to 5 weeks of diuretic treatment. Based on these tests uric acid clearance and fractional excretion as well as presecretory reabsorption, tubular secretion and postsecretory reabsorption of uric acid were calculated.
Results and conclusions Hydrochlorothiazide increases plasma uric acid and decreases its renal excretion in hypertensive patients. Both diminished tubular secretion and accelerated postsecretory reabsorption of uric acid are responsible for hypcruricaemic action of hydrochlorothiazide. Indapamide does not change neither plasma uric acid nor its renal handling. It seems that in patients with essential hypertension and gout indapamide is the diuretic of choice.
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Keywords

essential hypertension; uric acid; hydrochlorothiazide; indapamide

About this article
Title

Effect of hydrochlorothiazide and indapamide on renal handling of uric acid in patients with essential hypertension

Journal

Arterial Hypertension

Issue

Vol 1, No 1 (1997)

Article type

Original paper

Pages

6-10

Published online

2000-02-10

Page views

1097

Bibliographic record

Nadciśnienie tętnicze 1997;1(1):6-10.

Keywords

essential hypertension
uric acid
hydrochlorothiazide
indapamide

Authors

Andrzej Tykarski
Anna Posadzy-Małaczyńska
Paweł Łopatka
Jerzy Głuszek
Danuta Musialik
Bożena Raszeja-Wanic

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