Hyperuricemia Questions & Answers

Updated: Aug 31, 2018
  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Questions & Answers

Overview

What is hyperuricemia?

What are the possible consequences of hyperuricemia?

What affects the blood levels of uric acid in hyperuricemia?

What is the pathophysiology of uric acid relevant to hyperuricemia?

What is the role of urate/anion exchange in the pathogenesis of hyperuricemia?

What is the correlation between urate secretion and serum urate concentration in the pathophysiology of hyperuricemia?

What are the causes of hyperuricemia?

What is the role of underexcretion of urate in the pathogenesis of hyperuricemia?

What is the role of overproduction of urate in the pathogenesis of hyperuricemia?

What causes combined underexcretion and overproduction of urate in hyperuricemia?

What is the role of inflammation in the pathogenesis of hyperuricemia?

What is the role of zinc and magnesium in the pathogenesis of hyperuricemia?

What is the prevalence of hyperuricemia in the US?

What is the global prevalence of hyperuricemia?

What is the incidence of hyperuricemia in hypertension?

What are the causes of co-morbid health conditions with hyperuricemia?

What is the mortality rate of hyperuricemia?

What are the racial predilections of hyperuricemia?

How does the incidence of hyperuricemia vary by sex?

How does the prevalence of hyperuricemia vary by age?

Presentation

Which patient history is characteristic of hyperuricemia?

What are the symptoms of gout and nephrolithiasis in hyperuricemia?

What are the symptomatic presentations of hyperuricemia?

What are the three pathophysiologic categories of hyperuricemia?

What are the causes of uric acid underexcretion in hyperuricemia?

What are the causes of uric acid overproduction in hyperuricemia?

What is the causes of combined underexcretion and overproduction of uric acid in hyperuricemia?

DDX

What are the differential diagnoses for Hyperuricemia?

Workup

Which lab studies are performed in the workup of hyperuricemia?

Which studies are performed in evaluation of hyperuricemia with persistently elevated uric acid levels?

How is a 24-hour urine collection performed in the evaluation of hyperuricemia?

What are the categories of hyperuricemia?

When is fractional excretion of urate on a low-purine diet test indicated in the assessment of hyperuricemia?

What is the formula to obtain the fractional excretion of urate in the workup of hyperuricemia?

What are the uric acid reference intervals for patients on a low-purine diet and normal renal function the assessment of hyperuricemia?

How are the results of fractional excretion of urate test interpreted in the workup of hyperuricemia?

What is the role of spot urine collection in the workup of hyperuricemia?

What is the role of imaging studies in the workup of hyperuricemia?

What is the role of joint aspiration in the workup of hyperuricemia?

Treatment

What are the treatment options for asymptomatic hyperuricemia?

In which clinical situation is hyperuricemia symptomatic?

What is the initial goal for treatment of acute gouty arthritis in hyperuricemia?

What is the role of colchicine in the treatment of hyperuricemia?

Which medications are used to treat acute gouty arthritis in hyperuricemia?

What are the indications for starting chronic gout therapy in patients with hyperuricemia?

Which medications are used in the treatment of chronic gout in patients with hyperuricemia?

What is the role of probenecid in the treatment of hyperuricemia?

How is allopurinol used in the treatment of hyperuricemia?

Who are the ideal candidates for allopurinol treatment of chronic gout and hyperuricemia?

What is the role of allopurinol in the treatment of hyperuricemia?

What is the role of febuxostat in the treatment of hyperuricemia?

What is the safety of febuxostat in the treatment of hyperuricemia?

What is the role of lesinurad (Zurampic) in the treatment of hyperuricemia?

How is lesinurad administered for treatment of chronic gout in patients with hyperuricemia?

How is lesinurad monitored in the treatment of hyperuricemia?

What is the role of pegloticase in the treatment of hyperuricemia?

How is hyperuricemia treated in patients who develop uric acid stones?

What is the role of potassium citrate and sodium bicarbonate or acetazolamide in the treatment of hyperuricemia?

What is the role of hydration in the medical care of hyperuricemia?

How is uric acid nephropathy managed in patients with hyperuricemia?

What is the role of rasburicase in the treatment of hyperuricemia?

Which specialist consultations are beneficial in the treatment of hyperuricemia?

Which dietary modifications are needed during treatment of hyperuricemia?

Which activity modifications are needed during the treatment of hyperuricemia?

Medications

What are the goals of drug treatment for hyperuricemia?

What is the basis of drug treatment selection for hyperuricemia?

What is the role of rasburicase in drug treatment for hyperuricemia?

Which medications in the drug class Alkalinizing Agent, Oral are used in the treatment of Hyperuricemia?

Which medications in the drug class Urate Oxidase Enzyme (Recombinant) are used in the treatment of Hyperuricemia?

Which medications in the drug class Glucocorticoids are used in the treatment of Hyperuricemia?

Which medications in the drug class Carbonic Anhydrase Inhibitors are used in the treatment of Hyperuricemia?

Which medications in the drug class Antigout Agents are used in the treatment of Hyperuricemia?

Which medications in the drug class Uricosuric Agents are used in the treatment of Hyperuricemia?

Which medications in the drug class Selective Uric acid Reabsorption Inhibitor (SURI) are used in the treatment of Hyperuricemia?

Which medications in the drug class Xanthine Oxidase Inhibitors are used in the treatment of Hyperuricemia?

Which medications in the drug class Nonsteroidal Anti-Inflammatory Drugs are used in the treatment of Hyperuricemia?

Follow-up

What is included in long-term monitoring of hyperuricemia?

How is hyperuricemia prevented?

What are the possible complications of hyperuricemia?

What should be included in patient education about hyperuricemia?