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hyperuricaemia

Hyperuricaemia

aetiology:

oncologic settings:

associated benign conditions

summary:

  • serious and if recognised early, results in significant reduction in morbidity
  • pathogenesis: increased production, decreased excretion
  • major source is cell breakdown
  • major excretory PW is renal
  • with increased uric acid in kidneys ⇒ crystals in distal tubules ⇒ intrarenal obstruction ⇒ ARF
  • chronically elevated levels: renal colic, obstructive uropathy, CRF

May cause 3 types of renal disease:

  • acute hypeuricaemic nephropathy
  • uric acid nephrolithiasis
  • gouty nephropathy

symptoms & signs in the oncologic patient:

  • +/- asymptomatic
  • underlying malignancy
  • with symptoms of tumour lysis syndrome
  • acute oliguria following chemotherapy
  • renal colic

investigations:

  • serum uric acid
  • U + E

management in the oncologic patient:

  • pretreat hyperuricaemia- prior to chemo or XRT
  • hydration
  • consider Na Bicarbonate (alkalinise urine), diuretics
  • mannitol
  • peritoneal dialysis/haemodialysis

management in the patient with gout

hyperuricaemia.txt · Last modified: 2008/09/30 22:01 (external edit)