Nephrology Book

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Hyperuricemia

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  1. See Also
    1. Uric Acid
    2. Gout
  2. Pathophysiology: Asymptomatic hyperuricemia
    1. Treat only if 24 hour Uric Acid excretion >1000 mg
    2. Over 95% with elevated Uric Acid remain asymptomatic
  3. Decreased renal excretion of Uric Acid (90%)
    1. Primary idiopathic hyperuricemia
    2. Chronic Renal Insufficiency
    3. Polycystic Kidney Disease
    4. Diabetes Insipidus
    5. Hypertension
    6. Dehydration or starvation ketosis
    7. Acidosis
      1. Lactic Acidosis
      2. Diabetic Ketoacidosis
    8. Down Syndrome
    9. Lead nephropathy or Lead Poisoning
    10. Berylliosis
    11. Sarcoidosis
    12. Hyperparathyroidism
    13. Hypothyroidism
    14. Pregnancy Induced Hypertension
    15. Bartter's Syndrome
    16. Medications and other intakes
      1. Acute Alcohol ingestion
      2. Diuretics
        1. Limit Hydrochlorothiazide to 25 mg/day
        2. Consider other antihypertensives
      3. Cyclosporine
      4. Nicotinic Acid
      5. Salicylates (less than 2 grams per day)
      6. Pyrazinamide
      7. Ethambutol
  4. Overproduction of Uric Acid (10%)
    1. Inborn error of metabolism
      1. HGPRTase deficiency
        1. Hypoxanthine-guanine phosphoribosyl-transferase
      2. PRPP synthase overactivity
        1. Phosphoribosyl pyrophosphate synthetase
    2. Hemolysis
    3. Myeloproliferative disorder
    4. Lymphoproliferative disorder
    5. Solid tumors
    6. Polycythemia Vera
    7. Medications
      1. Strong response to Chemotherapy or cytotoxic agents
      2. Pancreatic extracts
      3. Vitamin B12
    8. Alcohol intake (especially beer)
    9. Purine-rich diet
      1. See Purine Content in Foods
    10. Obesity
    11. Severe Psoriasis
    12. Tissue necrosis
  5. Combination: Overproduction and decreased excretion
    1. Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD)
    2. Fructose-1-Phosphate Aldolase Deficiency
    3. Shock
    4. Alcohol ingestion

Hyperuricemia (C0740394)

Definition (MSH)Excessive URIC ACID or urate in blood as defined by its solubility in plasma at 37 degrees C; greater than 0.42mmol per liter (7.0mg/dL) in men or 0.36mmol per liter (6.0mg/dL) in women. This condition is caused by overproduction of uric acid or impaired renal clearance. Hyperuricemia can be acquired, drug-induced or genetically determined (LESCH-NYHAN SYNDROME). It is associated with HYPERTENSION and GOUT.
Definition (CSP)excessive uric acid or urate in blood as defined by its solubility in plasma at 37 degrees Celsius; greater than 0.42mmol per liter (7.0mg/dl) in men or 0.36mmol per liter (6.0mg/dl) in women; this condition is caused by overproduction of uric acid or impaired renal clearance; hyperuricemia can be acquired, drug-induced or genetically determined; it is associated with hypertension and gout.
Definition (NCI)A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs.
Definition (NCI)Elevated blood concentrations of uric acid.
ConceptsDisease or Syndrome (T047)
EnglishHYPERURICAEMIA, Hyperuricemia, URIC ACID ELEVATED, URIC ACID RETENTION, Uricacidaemia, Uricacidemia
Spanishhiperuricemia, uricacidemia
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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