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Hyperuricemia

Hyperuricemia is defined as a serum uric acid concentration >7.0 mg/dL in males and >6.0 mg/dL in females. Body mass index and alcohol intake are the most important predictors of hyperuricemia and gout in the majority of individuals.

Acquired causes of hyperuricemia:

Urate overproduction: excess dietary purine consumption, accelerated hepatic ATP degradation in alcohol abuse or fructose ingestion, and increased nucleotide turnover in myeloproliferative and lymphoproliferative disorders

Urate underexcretion: renal disease, lead nephropathy (saturnine gout), inhibition of tubular urate secretion (keto- and lactic acidosis), and miscellaneous causes such as hyperparathyroidism, hypothyroidism, and respiratory acidosis

Drugs that cause hyperuricemia due to decreased renal excretion of urate (mnemonic CAN’T LEAP )

Cyclosporine

Lasix (furosemide) (and other loop diuretics)

Alcohol

Ethambutol

Nicotinic acid

Aspirin (low dose)

Thiazides

Pyrazinamide

Other drugs that can cause hyperuricemia by unknown mechanisms include levodopa, theophylline, and didanosine.


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