Causes of Hyperuricemia

Increased production

 • Solid-organ transplant

 • Tumor lysis syndrome

 • Rhabdomyolysis

 • Lesch Nyhan syndrome

Decreased excretion

 • Functionally normal kidneys

     - diuretics

     - salicylates

     - pyrazinamide and ethambutol

     - nicotinic acid

     - cyclosporine (ciclosporin)-reduced glomerular filtration rate

 • Associated with chronic kidney disease (CKD) stages 2-5

     - preeclampsia

Both Increased Production, and Decreased Excretion

 • Ethanol -> lactic acid + uric acid

 • Ethanol -> xanthine inhibits xanthine dehydrogenase and accelerates adenosine degradation -> uric acid

 • Beer -> purines -> uric acid

 • Fructose (soft drinks) -> uric acid: competes with the uric acid for transport protein in the kidney

Starvation

 • Ketones compete with uric acid for excretion

 • Increases conversion of purines to uric acid



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