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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The lack of effect of URAT1 inhibitors on renal excretion of urate was independent of the renal function of hypouricemic patients. Thirty-two patients with hypertension and nine patients with idiopathic renal hypouricemia five with and four without hypertension were enrolled for this study.

As the primary outcome, the uric acid levels of the losartan group decreased from 7. J Pharmacol Exp Ther Conflict of interest statement: Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease?

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

However, it is still unknown whether the inhibitory effect of losartan on URAT1 contributes to its uricosuric action in humans.

However, candesartan did not influence Cur 5. A follow-up study was conducted by the same study investigators which evaluated an additional outcome of urinary acid excretion [ Khan et al. Abdominal surgery also has a uricosuric effect, as well as the potential to precipitate an acute attack of gout.


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. This study did not complete a safety analysis [ Elisaf et al.

Future studies are needed with additional ARBs and with losartan evaluating endpoints such as prevention of gout attacks or gout-related hospitalizations. Several uricosurics are known to act in vitro by blocking the function of a protein encoded by the gene SLC22A12also known as urate transporter 1 or URAT1.

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Several of the studies were conducted within a short time frame lasting only for several weeks [ Dang et al. Renal handling of uric acid in normal and gouty subject: This adverse effect was not expected, although this raises an important concern with chronically elevated serum uric acid levels precipitating gout attacks.

Sign In or Create an Account. A total of 57 patients were analyzed at 12 weeks.


The renal-specific transporter mediates facilitative transport of organic anions at the brush border membrane of mouse renal tubules. The two treatment groups were comparable in terms of age, BMI, weight, height, baseline sitting BP, fasting plasma glucose levels, serum levels of total cholesterol, and udicosuric.

In the losartan monotherapy group, uric acid levels decreased from 8.

In the hydrochlorothiazide monotherapy group, uric acid levels increased from 8. Four individuals experienced an acute gouty attack after being switched from losartan back to enalapril therapy.

Uricosuric effect of losartan in patients with renal transplants.

Following combination therapy, the addition of losartan further decreased uric acid levels from 5. URAT1 is the central mediator in the transport of uric acid from the kidney into the blood. In this study, we found that in hypertensive patients the effects of losartan on renal excretion of urate differed significantly from those of candesartan.

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Formula and nomogram for the sphygmomanometric calculation of the mean arterial pressure. The angiotensin receptor blocker losartan inhibited urate transporter 1 URAT1 according to in vitro experiments.

Table 1 summarizes the SLC22A12 genes and clinical characteristics of five hypertensive patients and four normotensive patients with idiopathic renal hypouricemia. Effects of the angiotensin II antagonist valsartan on blood pressure, proteinuria, and renal hemodynamics in patients with chronic renal failure and hypertension. Wilcoxon’s test was used to assess the effect of losartan on hypouricemic patients. Several gout attacks occurred through each phase of the study.

These findings suggested that losartan inhibited URAT1 and thereby it lowered Sur levels in hypertensive patients. These findings highlight a niche for the incorporation of losartan into therapeutic regimens for individuals with thiazide diuretic-induced hyperuricemia.

Uricosuric effect of losartan in patients with renal transplants.

Of note, in the losartan group, the uric acid levels decreased with no effect on serum creatinine, while in the candesartan group, there was no change in uric uricouric levels but there was a slight increase in serum creatinine. In addition, it is estimated that employed individuals diagnosed with gout miss 5 days more per year than their counterparts without the disease.

Ann Rheum Dis Conclusion This review explored evidence for ARBs and the reduction of serum uric acid levels and increased fractional excretion of uric acid.