Causes of Hyperuricemia
Increased production
• Solid-organ transplant
• Tumor lysis syndrome
• Rhabdomyolysis
• Lesch Nyhan syndrome
Decreased excretion
• Functionally normal kidneys
- diuretics
- salicylates
- pyrazinamide and ethambutol
- nicotinic acid
- cyclosporine (ciclosporin)-reduced glomerular filtration rate
• Associated with chronic kidney disease (CKD) stages 2-5
- preeclampsia
Both Increased Production, and Decreased Excretion
• Ethanol -> lactic acid + uric acid
• Ethanol -> xanthine inhibits xanthine dehydrogenase and accelerates adenosine degradation -> uric acid
• Beer -> purines -> uric acid
• Fructose (soft drinks) -> uric acid: competes with the uric acid for transport protein in the kidney
Starvation
• Ketones compete with uric acid for excretion
• Increases conversion of purines to uric acid
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