To the Editor:—
We would like to comment on the interesting article by Brest et al (195:42, 1966).We are reluctant to endorse blanket prophylactic administration of uricosuric agents to patients with diuretic-induced hyperuricemia for the following reasons:
Except for gout and uric acid stone formation, there is no evidence that hyperuricemia is causally related to the other listed diseases. In the latter conditions hyperuricemia could be a coincidental chemical finding.
In our Diuretic Clinic where we have studied hundreds of patients, receiving a variety of diuretics, for very long periods of time, the incidence of hyperuricemia is about 50%, yet the overwhelming majority of these patients showing persistent hyperuricemia have not shown any ill effects from this deviation, including gout. Indeed, considering the vast clinical use of these drugs over the last several years, one should have begun to see by now a heightened incidence of