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  • 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


oncologic settings:

associated non-malignant conditions


  • 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


  • 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: 2022/08/17 09:41 by wh

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