UA is the main metabolite of adenosine triphosphate degradation, and increased UA excretion has been observed in patients with respiratory failure.29 However, in such patients, serum UA levels were not decreased or changed by treatment,29 implicating increased UA production, rather than abnormal UA renal handling, in hypoxic patients. necrosis factor- (TNF-) were measured in 16 patients. Sixteen patients (26.7%) had hypouricemia (UA, 1.68 0.52 mg/dL [100 31 mol/L]). No differences in age, sex, symptoms, vital signs, hemogram, or other biochemistry data existed between the hypouricemic and normouricemic groups. Fractional excretion (FE) of UA (FEUA) in 12 hypouricemic patients was 39.6% 23.4%, significantly greater than that of 31 normouricemic patients (16.4% 11.4%; 0.0001). After adjustments for age and sex, high FEUA was significantly associated with the lowest blood oxygenation (-)-BAY-1251152 (= 0.001; (-)-BAY-1251152 = ?0.624). The number of catastrophic outcomes (endotracheal intubation and/or death) adjusted for older age and sex showed that hypouremic patients had an odds percentage of 10.57 (confidence interval, 2.33 to 47.98; = 0.002). Kaplan-Meier curves for catastrophic outcomeCfree results showed significant variations between individuals with normouricemia or hypouricemia (= 0.01). Serum IL-8 levels correlated significantly with FEUA ( 0.001; = 0.785) and inversely with serum UA level (= 0.044; = (-)-BAY-1251152 ?0.509); neither IL-6 nor TNF- level (-)-BAY-1251152 showed such correlations. One fourth of individuals with SARS developed hypouricemia, which might result from a defect in renal UA handling and was associated with a high serum IL-8 level. Renal hypouricemia is an ominous sign in individuals with SARS. less than 0.05 is considered statistically significant. Results Patient characteristics Patient age was 47 17 years, and there were 30 ladies and 30 males. Thirty-five, 54, and 55 individuals experienced serum UA levels measured at 1 to 5, 6 to 9, and 10 to 15 days after fever onset, respectively. Sixteen individuals (26.7%) were hypouricemic, having a serum UA level of 1.68 0.59 mg/dL (100 35 mol/L); the remainder experienced a serum UA level of 4.56 1.41 mg/dL (271 84 mol/L). As demonstrated in Fig 1, at each period, hypouricemic individuals experienced lower serum UA levels than normouricemic individuals. In hypouricemic individuals, the lowest serum UA level was observed 6 to 9 days after the onset of fever (= 0.001 compared with days 1 to 5) and returned to baseline 10 to 15 days after fever onset (= 0.565 compared with days 1 to 5). Conversely, serum UA levels in normouricemic individuals were unchanged during this time (= 0.770). Eleven hypouricemic individuals experienced serum UA levels return to normal (UA 2.5 mg/dL) after fever onset (day time 12.3 1.9).2 Four individuals remained hypouricemic after day time 16, and 1 patient was without UA data after day time 12. Individuals with prolonged hypouricemia showed a graver prognosis than individuals with corrected hypouricemia (intubated or deceased, = 0.016). Open in a separate windowpane Fig 1 Serum UA levels in individuals with SARS measured in different periods after fever: 1 to 5, 6 to 9, and 10 to 14 days. Sixteen individuals were identified as hypouricemic (dotted pub), and 44 individuals, normouricemic (black pub). Figures in parentheses show the number of individuals with serum UA measurements in that period. *= 0.001. There were no variations in age, sex, symptoms (ie, sore throat, runny nose, cough, myalgia, and diarrhea), or vital signs on admission between the 2 organizations (Table 1). Prevalences of hypertension, diabetes, and ischemic heart disease Mouse monoclonal to GAPDH were the same between the 2 organizations (Table 1). Table 1 Characteristics of Individuals 0.0001). All hypouricemic individuals had improper uricosuria (FEUA 10%). The inverse correlation of FEUA with serum UA level was significant (= ?0.565; 0.001; Fig 2). Three hypouricemic individuals experienced a positive urine glucose test result recognized with Multistix (Bayer, Taiwan), including 2 individuals with diabetes with plasma glucose levels greater than 200 mg/dL ( 11.1 mmol/L). Open in a separate windowpane Fig 2 The relationship between serum UA level and FEUA in 43 individuals with SARS. Dashed lines show FEUA of 10% (horizontal) and serum UA level (-)-BAY-1251152 of 2.5 mg/dL (149 mol/L; vertical). To convert UA in mg/dL to mol/L, multiply by 59.48..
UA is the main metabolite of adenosine triphosphate degradation, and increased UA excretion has been observed in patients with respiratory failure