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Limited Value of Uric Acid to Creatinine Ratios in Estimating Uric Acid Excretion

ROBERT L. WORTMANN, M.D.; and IRVING H. FOX, M.D.
[+] Article and Author Information

Grant support: by grants AM19674 and 5M01RR42 from the U. S. Public Health Service.

▸Requests for reprints should be addressed to Irving H. Fox, M.D.; University Hospital, Clinical Research Center, W-4642 Main Hospital; Ann Arbor, MI 48109.


Ann Arbor, Michigan


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;93(6):822-825. doi:10.7326/0003-4819-93-6-822
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The value of the uric acid to creatinine ratio and the uric acid to creatinine clearance ratio in predicting 24-hour urinary uric acid excretion was assessed in 49 patients with normal enzyme activity and 22 patients with purine enzyme deficiencies. A 24-hour urinary uric acid to creatinine ratio greater than 0.75 was found in six of nine patients with a partial deficiency of hypoxanthine-guanine phosphoribosyltransferase and in all patients with Lesch-Nyhan syndrome. A ratio of less than 0.10 suggested xanthinuria or severe purine nucleoside Phosphorylase deficiency. Neither ratio calculated from 2-hour timed collections or the 24-hour specimen showed a high correlation with 24-hour urine uric acid excretion in patients with normal enzyme activity, perhaps because of a diurnal variation in urinary uric acid excretion. The spoturine uric acid to creatinine ratio does not accurately predict the 24-hour urine uric acid excretion in patients with normal enzyme activity.

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