Hyperuricemia

	WikiDoc Resources for Hyperuricemia
Articles
Most recent articles on Hyperuricemia Most cited articles on Hyperuricemia Review articles on Hyperuricemia Articles on Hyperuricemia in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Hyperuricemia Images of Hyperuricemia Photos of Hyperuricemia Podcasts & MP3s on Hyperuricemia Videos on Hyperuricemia
Evidence Based Medicine
Cochrane Collaboration on Hyperuricemia Bandolier on Hyperuricemia TRIP on Hyperuricemia
Clinical Trials
Ongoing Trials on Hyperuricemia at Clinical Trials.gov Trial results on Hyperuricemia Clinical Trials on Hyperuricemia at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Hyperuricemia NICE Guidance on Hyperuricemia NHS PRODIGY Guidance FDA on Hyperuricemia CDC on Hyperuricemia
Books
Books on Hyperuricemia
News
Hyperuricemia in the news Be alerted to news on Hyperuricemia News trends on Hyperuricemia
Commentary
Blogs on Hyperuricemia
Definitions
Definitions of Hyperuricemia
Patient Resources / Community
Patient resources on Hyperuricemia Discussion groups on Hyperuricemia Patient Handouts on Hyperuricemia Directions to Hospitals Treating Hyperuricemia Risk calculators and risk factors for Hyperuricemia
Healthcare Provider Resources
Symptoms of Hyperuricemia Causes & Risk Factors for Hyperuricemia Diagnostic studies for Hyperuricemia Treatment of Hyperuricemia
Continuing Medical Education (CME)
CME Programs on Hyperuricemia
International
Hyperuricemia en Espanol Hyperuricemia en Francais
Business
Hyperuricemia in the Marketplace Patents on Hyperuricemia
Experimental / Informatics
List of terms related to Hyperuricemia

Template:DiseaseDisorder infobox

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hyperuricemia (American English), or hyperuricaemia (British English), is the presence of high levels of uric acid in the blood. The upper end of the normal range is 360 micromol/L (6 mg/dL) for women and 400 micromol/L (6.8 mg/dL) for men. ^[1]

Causes

Hyperuricemia is caused either by accelerated generation of uric acid through purine metabolism or by impaired excretion in the kidney, or by high levels of fructose in the diet.^[2]^[3]

Consumption of purine-rich diets is one of the main causes of hyperuricemia. Other dietary causes are ingestion of high protein and fat, and starvation. Starvation results in the body metabolizing its own muscle mass for energy, in the process releasing purines into the bloodstream. Purine bases composition of foods varies. Foods with higher content of purine bases adenine and hypoxanthine are suggested to be more potent in exacerbating hyperuricemia.^[4]

Humans lack urate oxidase, an enzyme which degrades uric acid. Increased levels predispose for gout and (if very high) renal failure. Apart from normal variation (with a genetic component), tumor lysis syndrome produces extreme levels of uric acid, mainly leading to renal failure. The Lesch-Nyhan syndrome is also associated with extremely high levels of uric acid. The Metabolic syndrome often presents with hyperuricemia, while a hyperuricemic syndrome is also common in Dalmatian dogs.

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Ciclosporin, Cytarabine,Epirubicin , Ethambutol, Ethacrynic Acid, Flurbiprofen, Hydrochlorothiazide, Ibrutinib, Nelarabine, Nizatidine,Pergolide, Pramipexole, Pyrazinamide, Romidepsin, Siltuximab, Thalidomide, Thioguanine
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Treatment

Aquaretics
Allopurinol (200-300mg by mouth once daily) use is controversial. By reducing uric acid production in the body, uric acid stores in the body could be mobilized leading to nephrolithiasis or gout.
Alkalinizing the urine with Sodium Bicarbonate, Stohl's Solution, or Acetazolamide.
Low purine diet (see gout).
Febuxostat has been investigated.^[5]

External links

Template:FPnotebook
Purine Content of Food at dietaryfiberfood.com

References

↑ Chizyński K, Rózycka M (2005). "Hyperuricemia". Pol. Merkur. Lekarski (in Polish). 19 (113): 693–6. PMID 16498814.
↑ Nakagawa T, Hu H, Zharikov S; et al. (2006). "A causal role for uric acid in fructose-induced metabolic syndrome". Am. J. Physiol. Renal Physiol. 290 (3): F625–31. doi:10.1152/ajprenal.00140.2005. PMID 16234313.
↑ Mayes PA (1993). "Intermediary metabolism of fructose". Am. J. Clin. Nutr. 58 (5 Suppl): 754S–765S. PMID 8213607.
↑ Brule, D. Sarwar, G. and Savoie (1992). "Changes in Serum Uric Acid Levels in Normal Human Subjects Fed Purine-Rich Foods Containing Different Amounts of Adenine and Hypoxanthine". Journal of American College of Nutrition. 11 (3): 353–358.
↑ Becker MA, Schumacher HR, Wortmann RL; et al. (2005). "Febuxostat compared with allopurinol in patients with hyperuricemia and gout". N. Engl. J. Med. 353 (23): 2450–61. doi:10.1056/NEJMoa050373. PMID 16339094.

Template:Metabolic pathology

de:Hyperurikämie

Template:WikiDoc Sources

[1] Chizyński K, Rózycka M (2005). "Hyperuricemia". Pol. Merkur. Lekarski (in Polish). 19 (113): 693–6. PMID 16498814.

[2] Nakagawa T, Hu H, Zharikov S; et al. (2006). "A causal role for uric acid in fructose-induced metabolic syndrome". Am. J. Physiol. Renal Physiol. 290 (3): F625–31. doi:10.1152/ajprenal.00140.2005. PMID 16234313.

[3] Mayes PA (1993). "Intermediary metabolism of fructose". Am. J. Clin. Nutr. 58 (5 Suppl): 754S–765S. PMID 8213607.

[4] Brule, D. Sarwar, G. and Savoie (1992). "Changes in Serum Uric Acid Levels in Normal Human Subjects Fed Purine-Rich Foods Containing Different Amounts of Adenine and Hypoxanthine". Journal of American College of Nutrition. 11 (3): 353–358.

[5] Becker MA, Schumacher HR, Wortmann RL; et al. (2005). "Febuxostat compared with allopurinol in patients with hyperuricemia and gout". N. Engl. J. Med. 353 (23): 2450–61. doi:10.1056/NEJMoa050373. PMID 16339094.

[1]

[2]

[3]

[4]

[5]