Diuretic induced gout: a multifactorial condition.

Fifteen patients with clinical gout occurring after long term treatment with diuretics were studied retrospectively. In all 15 patients one or more additional factors were present which might have contributed to the hyperuricaemia and gout. The most common of these was the impairment of the glomerular filtration rate. Twenty five other patients receiving long term treatment with diuretics who did not have gout were also studied. The concentrations of uric acid, urea, and creatinine were, in general, markedly lower in these patients than in those who had developed gout. It is concluded that diuretic induced gout occurs in patients in whom there is an additional cause of hyperuricaemia, usually impaired renal function.