Comparison of urinary acidification and ammonium excretion in normal and gouty subjects

The urinary acidification response to stimulation of the distal transtubular pH gradient and to the production of systemic acidosis was compared in ten gouty patients and ten normal subjects. Studies were performed at two levels of phosphate intake in order to influence titratable acid excretion. The data suggest that gouty patients do not establish a greater pH gradient across the distal tubule than normal subjects, that there is no restriction of ammonia diffusion in gouty patients, that gouty patients tend to handle an acid load by preferentially excreting titratable acid rather than ammonium, and that a modest defect in ammonia production which can best be elicited during dietary restriction of phosphate may exist in gouty patients.