On the Mechanism of the Paradoxical Effect of Salicylate on Urate Excretion

Abstract

In 1959 Yu and Gutman reported that aspirin in a dose of 2g/day or less resulted in decreased urate excretion while at doses greater than 3g/day, urate excretion was increased (1). They also found that alkalinization of the urine with bicarbonate increased both salicylate and urate excretion. These results were interpreted as showing that low concentrations of salicylate in tubular urine inhibited tubular secretion of urate and high concentrations inhibited both tubular secretion of urate and reabsorption of urate. Since the overall result of tubular transport of urate is net re-absorption, uricosuria appeared when tubular salicylate concentrations were sufficiently increased.

Supported by grants from the Kroc Foundation, the New York Chapter of the Arthritis Foundation, the General Clinical Research Center Program of the National Institutes of Health, and from the Irma T. Hirschl Career Scientist Award (HSD)