+-load (acidic diet) and others composed of less protein and more vegetable-fruit rich food materials (alkaline diet). This is a crossover study within some limitations. Healthy female students, who had no medical problems at the regular physical examination provided by the university, were enrolled in this consecutive 5-day study for each test. From whole-day collected urine, total volume, pH, organic acid, creatinine, uric acid, titratable acid and all cations (Na+,K+,Ca2+,Mg2+,NH4,SO4,PO4) necessary for the estimation of acid–base balance were measured. In the early morning before breakfast of the 1st, 3rd and 5th experimental day, we sampled 5?mL of blood to estimate the creatinine and uric acid concentration in serum. Results and discussion Urine pH reached a steady state 3?days after switching from ordinary daily diets to specified regimens. The amount of acid generated ([SO4]-?organic acid???gut alkali)was linearly related with the excretion of acid (titratable acid-?[NH4 +]???[HCO3+?in urine is generated by the metabolic degradation of food materials. Uric acid and excreted urine pH retained a linear relationship, as reported previously. Among the five factors which are associated with calculating clearances for both uric acid and creatinine, we identified a conspicuous difference between acidic and alkaline diets in the uric acid concentration in serum as well as in urine; uric acid in the serum was higher in the acidic group than in the alkaline group, while uric acid in the urine in the acidic group was lower than that in the alkaline group. These changes of uric acid in acidic urine and in serum were reflected in the reduction of its clearance. From these observations, it is considered that uric acid may be reabsorbed more actively in acidic urine than in alkaline urine. Conclusion We conclude that alkalization of urine by eating nutritionally well-designed alkaline -prone food is effective for removing uric acid from the body." />
Effect of urine pH changed by dietary intervention on uric acid clearance mechanism of pH-dependent excretion of urinary uric acid
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  • 作者：Aya Kanbara (1)
    Yoshisuke Miura (1)
    Hideyuki Hyogo (2)
    Kazuaki Chayama (2)
    Issei Seyama (1)
  • 关键词：Hyperuricemia ; Gout ; Dietary intervention ; Acid–base
  • 刊名：Nutrition Journal
  • 出版年：2012
  • 出版时间：December 2012
  • 年：2012
  • 卷：11
  • 期：1
  • 全文大小：298KB
  • 参考文献：1. Kanbara A, Hakoda M, Seyama I: Urine alkalization facilitates uric acid excretion. / Nutri J 2010, 9:45. CrossRef
    2. Griesch A, Z?llner N: Effect of ribomononucleotides given orally on uric acid production in man. / Adv Exp Med Biol 1974, 41B:443-49.
    3. Clifford AJ, Riumallo JA, Young VR, Scrimshaw NS: Effect of oral purines on serum and urinary uric acid of normal, hyperuricemic and gouty humans. / J Nutr 1976, 106:428-34.
    4. Lennon EJ, Lemann J, Litzow JR: The effects of diet and stool composition on the net external acid balance of normal subjects. / J Clin Invest 1966, 45:1601-607. CrossRef
    5. Oh MS: A new method for estimating G-I absorption of alkali. / Kidney Int 1989, 36:915-17. CrossRef
    6. Van Slyke DD, Palmer WW: Studies of acidosis. XVI. The titration of organic acids in urine. / J Biol Chem 1920, 41:567-85.
    7. DuBois D, DuBois EF: A formula to estimate the approximate surface area if height and weight be known. / Arch Intern Med 1916, 17:863-71. CrossRef
    8. Brenner BM, Meyer TW, Hostetter TH: Dietary protein intake and the progressive nature of kidney disease: The role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. / N Engl J Med 1982, 307:652-59. CrossRef
    9. Giebisch G, Windhager E: Transport of urea, glucose, phosphate, calcium, magnesium and organic solutes. In / Medical Physiology. 2nd edition. Edited by: Boron WF, Boulpaep EL. SAUNDERS, Philadelphia; 2009:797-20. CrossRef
    10. Anzai N, Kanai Y, Endou H: New insights into renal transport of urate. / Curr Opin Rheumatol 2007, 19:151-57. CrossRef
    11. So A, Thorens B: Uric acid transport and disease. / J Clin Invest 2010, 120:1791-799. CrossRef
    12. Hagos Y, Stein D, Ugele B, Burckhardt G, Bahn A: Human Renal Organic Anion Transporter 4 Operates as an Asymmetric Urate Transporter. / J Am Soc Nephrol 2007, 18:430-39. CrossRef
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    14. Buttar HS, Li T, Ravi N: Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation. / Exp Clin Cardiol 2005, 10:229-49.
    15. American Diabetes Association: Nutritional Principles and Recommendations in Diabetes. / Diabetes Care 2004, 27:s36-s46. CrossRef
    16. NCI Division of Cancer Prevention: / Diet, food, nutrition. http://www.cancer.gov/prevention/lifestyle.html#diet
  • 作者单位：Aya Kanbara (1)
    Yoshisuke Miura (1)
    Hideyuki Hyogo (2)
    Kazuaki Chayama (2)
    Issei Seyama (1)

    1. Department of Nutrition and Health Promotion, Faculty for Human Development, Hiroshima Jogakuin University, 4-13-1 Ushita-higashi Higashi-ku, Hiroshima, 732-0063, Japan
    2. Department of Medicine and Molecular Sciences, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
  • ISSN：1475-2891
文摘
Background The finding reported in a previous paper - alkalization of urine facilitates uric acid excretion - is contradictory to what one might expect to occur: because food materials for the alkalization of urine contain fewer purine bodies than those for acidification, less uric acid in alkaline urine should have been excreted than in acid urine. To make clear what component of uric acid excretion mechanisms is responsible for this unexpected finding, we simultaneously collected data for the concentration of both creatinine and uric acid in serum as well as in urine, in order to calculate both uric acid and creatinine clearances. Methods Within the framework of the Japanese government’s health promotion program, we made recipes which consisted of protein-rich and less vegetable-fruit food materials for H-sup class="a-plus-plus">+-load (acidic diet) and others composed of less protein and more vegetable-fruit rich food materials (alkaline diet). This is a crossover study within some limitations. Healthy female students, who had no medical problems at the regular physical examination provided by the university, were enrolled in this consecutive 5-day study for each test. From whole-day collected urine, total volume, pH, organic acid, creatinine, uric acid, titratable acid and all cations (Na+,K+,Ca2+,Mg2+,NH4 +) and anions (Cl?/sup>,SO4 2?/sup>,PO4 ?/sup>) necessary for the estimation of acid–base balance were measured. In the early morning before breakfast of the 1st, 3rd and 5th experimental day, we sampled 5?mL of blood to estimate the creatinine and uric acid concentration in serum. Results and discussion Urine pH reached a steady state 3?days after switching from ordinary daily diets to specified regimens. The amount of acid generated ([SO4 2?/sup>]-?organic acid???gut alkali)was linearly related with the excretion of acid (titratable acid-?[NH4 +]???[HCO3 ?/sup>]), indicating that H-sup class="a-plus-plus">+?in urine is generated by the metabolic degradation of food materials. Uric acid and excreted urine pH retained a linear relationship, as reported previously. Among the five factors which are associated with calculating clearances for both uric acid and creatinine, we identified a conspicuous difference between acidic and alkaline diets in the uric acid concentration in serum as well as in urine; uric acid in the serum was higher in the acidic group than in the alkaline group, while uric acid in the urine in the acidic group was lower than that in the alkaline group. These changes of uric acid in acidic urine and in serum were reflected in the reduction of its clearance. From these observations, it is considered that uric acid may be reabsorbed more actively in acidic urine than in alkaline urine. Conclusion We conclude that alkalization of urine by eating nutritionally well-designed alkaline -prone food is effective for removing uric acid from the body.

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