Urate anion exchanger 1 (URAT1) (URAT1)

Renal urate handling is the physiological process responsible for maintaining systemic uric acid homeostasis through the coordinated action of various transporters in the kidney's proximal tubule [1, 5]. The system involves glomerular filtration followed by a complex model of reabsorption and secretion, where the most clinically significant target is Urate anion exchanger 1 (URAT1) [1, 8]. URAT1, encoded by the SLC22A12 gene, mediates the bulk of urate reabsorption from the tubular lumen back into the bloodstream [9, 16]. Other critical components include GLUT9, which handles basolateral transport, and ABCG2, which facilitates urate secretion [1, 14]. Impairment of this system is a primary cause of hyperuricemia, leading to gout and potentially contributing to chronic kidney disease [3, 4]. Therapeutic agents known as uricosurics target this system by inhibiting URAT1, thereby promoting the excretion of uric acid in the urine to lower serum concentrations [5, 15]. However, these therapies require careful management to avoid complications such as urolithiasis or acute obstructive uropathy caused by high concentrations of uric acid in the renal collecting system [11, 20].

Other names

SLC22A12Urate transporter 1Renal-specific transporterRSTOAT4LRenal urate transport system

Inhibition of URAT1-mediated urate reabsorption in the renal proximal tubule, leading to increased urinary excretion and decreased serum uric acid levels.