see also:

• gout
• uricosuric agents
• oncology

• whilst low serum urate levels are associated with lower muscle mass, chronic illness and thus is associated with higher morbidity¹⁾, high uric acid (urate) levels (hyperuricaemia) is associated with gout and may also be caused by oncologic conditions

• acute tumour lysis syndrome: post chemo of acute leukaemias and lymphomas
• multiple myeloma
• disseminated metastatic carcinoma

• gout
• hyperparathyroidism
• psoriasis
• sarcoid 
• renal failure of any cause + diuretics

• 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

• acute hypeuricaemic nephropathy
• uric acid nephrolithiasis
• gouty nephropathy

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

• serum uric acid
• U + E

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

• see gout