Management of Gout

To the Editor: Emmerson's review of the management of gout (Feb. 15 issue) 1 contains much useful information, but it also includes several arguable points. In their classic studies Gutman and Yü found that the excretion rate of urate in patients with gout was “almost invariably” within the normal range. 2 Thus, it is wrong to suggest that “decreased urinary excretion of urate often contributes to hyperuricemia” 1 and that measurements of urate clearance are clinically useful. Their studies led Gutman and Yü and many other early workers to conclude that kidney changes were “the result and not the cause” of hyperuricemia. Subsequent . . .