Hyperuricemia
Hyperuricemia is an elevated uric acid level in the blood (>7mg/dL).
- Uric acid is a product of pruine metabolism.
- Hyperurecemia is manifested as gout, urate nephropathy, and nephrolithiasis.
Etiology
Hyperuricemia can be due to increased production, decreased excretion, or both.
- Increased production
- Tumor lysis syndrome
- Hemolysis
- Rhabdomyolysis
- HPRT deficiency
- Purine-rich diet (meat, seafood, alcohol)
- Decreased excretion
- Acute/chronic renal disease
- Metabolic acidosis (keto/lactic acidosis)
Gout
Discussed below.
Urate nephropathy and nephrolithiasis
Urate excretion occurs mainly in the kidneys; uric acid crystals can be deposited in the tubular system, leading to urate nephropathy, and nephrolithiasis.
- Acute urate nephropathy. Sudden uric acid deposition may cause occlusion and lead to acute kidney injury.
- Etiology. Occurs predominantly due to tumor lysis syndrome.
- Treatment. IV fluids