Hyperuricaemia and preeclampsia: is there a pathogenic link?

Objective: A hypothesis, based on animal studies and human observational studies, was developed proposing a direct pathogenic link between hyperuricemia and preeclampsia. Epidemiological characteristics of preeclampsia such as its uniqueness to humans and an increased incidence of preeclampsia in multiple pregnancies, increased body mass index, renal and hypertensive disease all have uric acid as their common denominator. Animal studies have linked hyperuricaemia to hypertensive, cardiovascular and renal disease. The aim of the study was to determine whether lowering the serum uric acid levels in preeclampsia would affect biochemical parameters and hypertensive control.

Design: A randomized, double-blind, placebo controlled study.

Setting: A tertiary referral center.

Population: Forty women with preeclampsia between 26 and 32 weeks gestation.

Intervention: Probenecid 250 mg twice daily for seven days.

Main Outcome Measures: Renal function and haematological parameters, hypertensive control.

Results: In the Probenecid group, there was a significant drop in the serum uric acid levels. Lower uric acid levels in the Probenecid group had no significant effect on blood pressure. Patients in the Probenecid group had a significantly lower serum creatinine value at the end of the study when compared to patients in the placebo group. Other renal function parameters (creatinine clearance, urea, 24 h urinary protein excretion) did not show any significant difference between the two groups. Platelet count differed between the two groups with the platelet count being significantly higher in the Probenecid group at the end of the study.

Conclusion: The significant improvement in the platelet count in the Probenecid group warrants further study.