II. Pathophysiology: Asymptomatic Hyperuricemia

  1. Treat only if 24 hour Uric Acid excretion >1000 mg
  2. Over 95% with elevated Uric Acid remain asymptomatic

III. 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

IV. 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

V. Combination: Overproduction and decreased excretion

  1. Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD)
  2. Fructose-1-Phosphate Aldolase Deficiency
  3. Shock
  4. Alcohol ingestion

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Ontology: Hyperuricemia (C0740394)

Definition (NCI) Elevated blood concentrations of uric acid.
Definition (NCI_NCI-GLOSS) A buildup of uric acid (a byproduct of metabolism) in the blood. Hyperuricemia is a side effect of some anticancer drugs.
Definition (NCI_CTCAE) A disorder characterized by laboratory test results that indicate an elevation in the concentration of uric acid.
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.
Concepts Disease or Syndrome (T047)
MSH D033461
SnomedCT 166733000, 271198001, 237857006, 144021008, 35885006
English Hyperuricemia, HYPERURICAEMIA, HYPERURICEMIA, URIC ACID RETENTION, Uric acid retention, Hyperuricaemic, Hyperuricemia [Disease/Finding], hyperuricaemia, hyperuricaemic, Hyperuricaemia (disorder), Hyperuricaemia, Hyperuricemia (disorder), Uricacidaemia, Uricacidemia, hyperuricemia, uricacidemia, uricemia, Hyperuricemia, NOS, Uricacidemia, NOS, Hyperuricaemia [Ambiguous]
Dutch hyperurikemisch, urinezuur retentie, hyperurikemie, Hyperurikemie
French Hyperuricémique, Rétention d'acide urique, HYPERURICEMIE, RETENTION D'ACIDE URIQUE, Hyperuricémie
German Harnsaeure-Retention, hyperurikaemisch, HARNSAEURERETENTION, HYPERURIKAEMIE, Hyperurikaemie, Hyperurikämie
Italian Ritenzione di acido urico, Iperuricemico, Iperuricemia
Portuguese Retenção de ácido úrico, Hiperuricémico, HIPERURICEMIA, RETENCAO DE ACIDO URICO, Hiperuricemia
Spanish Retención de ácido úrico, Hiperuricémico, ACIDO URICO, RETENCION, HIPERURICEMIA, hiperuricemia (trastorno), hiperuricemia, uricacidemia, Hiperuricemia
Japanese 尿酸貯留, 高尿酸血症, コウニョウサンケツショウ, ニョウサンチョリュウ, コウニョウサンケッショウ
Swedish Hyperurikemi
Czech hyperurikémie, Hyperurikemický, Retence kyseliny močové, Hyperurikemie
Finnish Hyperurikemia
Russian GIPERURIKEMIIA, ГИПЕРУРИЦЕМИЯ, ГИПЕРУРИКЕМИЯ, GIPERURITSEMIIA
Polish Hiperurikemia
Hungarian Hyperuricaemia, Hyperuricaemiás, Húgysav retenció
Norwegian Økt urinsyre i blod, Hyperurikemi