hyperuricaemia
Table of Contents
Hyperuricaemia
see also:
Introduction
aetiology:
oncologic settings:
- acute tumour lysis syndrome: post chemo of acute leukaemias and lymphomas
- multiple myeloma
- disseminated metastatic carcinoma
associated non-malignant conditions
- renal failure of any cause + diuretics
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
- see gout
hyperuricaemia.txt · Last modified: 2022/08/17 09:41 by wh