Effect of long-term allopurinol administration on serial GFR in normotensive and hypertensive hyperuricemic subjects. Consumption of fructose- but not glucose-sweetened beverages for 10 weeks increases circulating concentrations of uric acid, retinol binding protein-4, and gamma-glutamyl transferase activity in overweight/obese humans Effects on uric acid, body mass index and blood pressure in adolescents of consuming beverages sweetened with high-fructose corn syrup Hyperuricemia after renal transplantation. Placebo-controlled double-blind dose-response study of the non-purine-selective xanthine oxidase inhibitor febuxostat (TMX-67) in patients with hyperuricemia (including gout patients) in japan: late phase 2 clinical study.
Acute experiments of uric acid infusion in animals and the clinical observation that in patients with gout there is an increased incidence of renal lesions , suggested that high levels of plasma uric acid may be detrimental to the kidney and cause a decrease in renal function . It is not known , however , whether hyperuricemia , not clinical ly associated with gout , causes kidney damage , nor is it known whether therapeutic reduction of serum uric acid levels slows the rate of the deterioration of renal function in such patients . To establish whether maintenance of normal plasma uric acid concentration in patients with hyperuricemia associated with various diseases has any effect on serial determination of GFR or slows the rate of kidney deterioration , this study was planned Background Prospect i ve studies in humans examining the effects of fructose consumption on biological markers associated with the development of metabolic syndrome are lacking . Therefore we investigated the relative effects of 10 wks of fructose or glucose consumption on plasma uric acid and RBP-4 concentrations , as well as liver enzyme ( AST , ALT , and GGT ) activities in men and women . Methods As part of a parallel arm study , older ( age 40–72 ) , overweight and obese male and female subjects ( BMI 25–35 kg/m2 ) consumed glucose- or fructose-sweetened beverages providing 25 % of energy requirements for 10 wks . Fasting and 24-h blood collection s were performed at baseline and following 10 wks of intervention and plasma concentrations of uric acid , RBP-4 and liver enzyme activities were measured . Results Consumption of fructose , but not glucose , led to significant increases of 24-h uric acid profiles ( P < 0.0001 ) and RBP-4 concentrations ( P = 0.012 ) , as well as plasma GGT activity ( P = 0.04 ) . Fasting plasma uric acid concentrations increased in both groups ; however , the response was significantly greater in subjects consuming fructose ( P = 0.002 for effect of sugar ) . Within the fructose group male subjects exhibited larger increases of RBP-4 levels than women ( P = 0.024 ) . Conclusions These findings suggest that consumption of fructose at 25 % of energy requirements for 10 wks , compared with isocaloric consumption of glucose , may contribute to the development of components of the metabolic syndrome by increasing circulating uric acid , GGT activity , suggesting alteration of hepatic function , and the production of RBP-4 Objective : The dietary intake of fructose-rich sugar-sweetened beverages ( SSB ) may have a significant role in raising serum uric acid ( SUA ) levels as well as the risk of contracting gout and cardiovascular risk factors . Our objective was to investigate the impact of SSB intake on SUA , body mass index ( BMI ) and systolic blood pressure ( SBP ) among adolescents in Taiwan . Methods : We evaluated data from 2727 representative adolescents who were multistage sample d from 36 Junior High schools in Taiwan . We cross-sectionally collected demographic , physical , dietary and anthropometric variables , and prospect ively measured clinical outcomes . Data were analyzed using multiple regression and logistic models adjusted for covariates . Results : We found that 87.7 % of adolescents were SSB drinkers , with 25.1 % drinking > 500 ml per day of such beverages . Increased SSB intake was associated with increased waist and hip circumferences , body fat , BMI , SBP and SUA . As compared with non-drinkers , SSB drinkers had a 3.2–4.9 elevated risk of obesity . The prevalence of hyperuricemia in heavy SSB  users ( 40.2–49.4 % ) was appreciably greater than that for non-users ( 24.2 % ) . Adolescents who consumed > 500 ml per day of heavy high-fructose corn syrup ( HFCS ) containing beverages had a 0.42 mg dl−1 higher SUA level and a 2.0–2.1 increased risk of developing hyperuricemia than non-drinkers . The consumption of HFCS-rich beverages was also found to interact with obesity in determining higher levels of SUA ( 2.2–2.4 mg dl−1 increases ) . Conclusion : High SSB consumption has a notable effect on increased levels of BMI and SUA . The intake of HFCS-rich beverages and BMI were likely to interactively strengthen SUA levels among obese adolescents Hyperuricemia is common in  cyclosporine-treated renal allograft recipients . An increased incidence of gout in patients receiving both diuretics and cyclosporine  has been reported , but the effect of hyperuricemia on renal allograft function has not been studied . In a prospect i ve , r and omized trial of cyclosporine and prednisone versus azathioprine , prednisone , and antilymphocyte globulin for immunosuppression in renal allograft recipients , 105 of 131 cyclosporine and prednisone-treated patients ( 80 percent ) experienced hyperuricemia ( serum uric acid level above 8 mg/dl ) and 13 of 131 ( 10 percent ) were severely hyperuricemic ( serum uric acid level above 14 mg/dl ) . In contrast , hyperuricemia developed in 63 of 115 patients ( 55 percent ) treated with azathioprine , prednisone , and antilymphocyte globulin ( p less than 0.002 ) . Despite the frequent occurrence of hyperuricemia , gout was rare . Clinical gout developed in six patients in the cyclosporine and prednisone group and in 0 patients in the azathioprine , prednisone , and antilymphocyte globulin group between 1 and 43 months ( median 22.5 months ) after transplantation . Neither severe hyperuricemia nor diuretic therapy were associated with a significantly increased incidence of gout . The mean serum creatinine concentration of severely hyperuricemic patients ( all on cyclosporine and prednisone ) was similar to that of normouricemic cyclosporine and prednisone patients ( 1.8 mg/dl versus 1.6 mg/dl , p greater than 0.2 ) , and the severely hyperuricemic patients had a 4-year graft survival rate of 90 percent . Asymptomatic hyperuricemia after renal transplantation does not adversely affect allograft function , requires no specific therapy , and is not a contraindication to use of diuretics BACKGROUND Allopurinol has been widely used for the treatment of hyperuricemia , however , it may be associated with various adverse effects . Febuxostat has been identified as a potentially safe and efficacious alternative . OBJECTIVES A multicenter study with r and omized , placebo-controlled , double-blind , parallel , intergroup comparison was carried out to evaluate the dose-response relationship , efficacy , and safety of febuxostat in 202 patients with hyperuricemia ( including patients with gout ) in Japan . METHODS The subjects were treated with febuxostat at fixed maintenance doses ( 20 - 80 mg/d ) or a placebo for 16 weeks . The percentage of patients achieving serum uric acid levels 6.0 mg/dL or less and the percent change in serum uric acid levels after 16 weeks of treatment were evaluated . RESULTS The percentage of patients achieving serum uric acid levels 6.0 mg/dL or less at 16 weeks was 87.8 % in the 80-mg/d dose group , 83.3 % in the 60-mg/d group , 82.9 % in the 40-mg/d group , 46.5 % in the 20-mg/d group , and 2.6 % in the placebo group ( P < 0.001 , Mantel-Haenszel test ) . A statistically significant dose-response relationship was found . The percent change in serum uric acid levels after 16 weeks of treatment differed significantly between each febuxostat dose group and the placebo group and increased in a dose-dependent manner above 40 mg/d . No deaths , events posing a clinical problem , or serious adverse reactions attributable to febuxostat were noted . Similar results were obtained regardless of gout history . CONCLUSIONS Febuxostat can safely reduce serum uric acid levels to 6.0 mg/dL or less in 80 % or more of patients with hyperuricemia ( including gout ) at doses of 40 mg/d or higher
These analyses do not support a uric acid-increasing effect  of isocaloric fructose intake in nondiabetic and diabetic participants .
Hypercaloric fructose intake may , however , increase uric acid concentrations .
Hyperuricemia is linked to gout and features of metabolic syndrome .
There is concern that dietary fructose may increase uric acid concentrations .