Safety of losartan in hypertensive patients with asymptomatic hyperuricemia.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Oct) 8:322A 1997
Losartan increases uric acid excretion and lowers serum uric acid by an unknown mechanism. It is unclear whether this is a class effect or an effect of this specific angiotensin II blocker. This increased uric acid excretion may theoretical precipitate uric acid stones.
Fifty five hypertensive subjects being treated with thiazides and whose serum uric acid levels were above 7mg/dl were randomized to four groups; a) losartan 50 mg daily, b) Losartan 50mg and HCTZ 50mg daily and c) HCTZ 50mg daily and d) placebo. The study lasted three weeks and all subjects were asked to consume a 2gm/kg protein diet the day before clinic visits. Serum uric acid, uric acid excretion rate, dihydrogen urate and urine PH were measured at baseline, and at day 1, 7, and 21.
Urine excretion rate of uric acid increased at 4 and 6 hours after losartan compared to baseline, while dihydrogen urate levels were reduced and urine PH rose significantly. These results were found on days 1, 7 and 21.
Comment: The authors concluded that the risk of uric acid crystallization was not increased. (George Mansoor, M.D., University of Connecticut)
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ASN 30th Annual Meeting, San Antonio
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