SEVERE RENAL HYPOURICEMIA SECONDARY TO HYPERBILIRUBINEMIA

A 64-year-old man with alcoholic liver cirrhosis had a progressive dec rease in the serum uric acid (UA) until it became undetectable, an inc rease renal UA clearance, mild glycosuria with normal serum glucose an d a decrease in the tubular reabsorption of phosphate in association w ith cholestasis secondary to a gallbladder carcinoma. All these abnorm alities returned to normal when the serum bilirubin levels decreased f ollowing surgical treatment. This clinical observation suggests that t he reversible renal tubular transport defect was secondary to high lev els of serum bilirubin.