Does asymptomatic hyperuricemia require treatment?
As a general rule, asymptomatic hyperuricemia should not be treated, though ultrasonographic studies have demonstrated that urate crystal deposition into soft tissues occurs in a minority of patients with asymptomatic hyperuricemia.
What causes asymptomatic hyperuricemia?
Asymptomatic hyperuricemia is a term traditionally applied to settings in which the serum urate concentration is elevated but in which neither symptoms nor signs of monosodium urate (MSU) crystal deposition disease, such as gout, or uric acid renal disease, have occurred.
Why is asymptomatic hyperuricemia not treated?
Treatment of asymptomatic hyperuricemia is not necessary in most patients, unless perhaps they have very high levels of uric acid or are otherwise at risk of complications, such as those with a personal or strong family history of gout, urolithiasis, or uric acid nephropathy.
Does CKD cause hyperuricemia?
In the case of CKD, renal excretion of uric acid is decreased, resulting in hyperuricemia. It is thought that the interstitial accumulation of sodium urate induces the deterioration of the disease.
How do you treat asymptomatic hyperuricemia?
Pharmacologic treatment for asymptomatic hyperuricemia carries some risk, is not considered beneficial or cost-effective, and generally is not recommended. However, these patients can be advised on lifestyle changes such as changes in diet, reduction in alcohol intake, and exercise, which may lower uric acid levels.
What is asymptomatic D?
Asymptomatic means there are no symptoms. You are considered asymptomatic if you: Have recovered from an illness or condition and no longer have symptoms. Have an illness or condition (such as early stage high blood pressure or glaucoma) but do not have symptoms of it.
How is hyperuricemia diagnosed?
How hyperuricemia is diagnosed. Your doctor may order blood and urine tests to measure creatinine levels, which determines kidney function, as well as uric acid levels. Blood is usually taken from a vein in your arm, typically on the inside of your elbow or on the back of your hand.
Is renal insufficiency asymptomatic?
Patients with CKD stages 1-3 are generally asymptomatic. Typically, it is not until stages 4-5 (GFR < 30 mL/min/1.73 m²) that endocrine/metabolic derangements or disturbances in water or electrolyte balance become clinically manifest.
Does hyperuricemia affect kidney function?
Experimental studies suggest that hyperuricemia causes kidney damage due to systemic and glomerular hypertension. One of several mechanisms suggested is inhibition of nitric oxide synthesis, which leads to arterial vasoconstriction.
Is asymptomatic hyperuricemia a serious condition?
Historically asymptomatic hyperuricemia was considered a benign laboratory abnormality with little clinical significance in the absence of gout or kidney stones. Yet, there is increasing evidence that asymptomatic hyperuricemia can predict the development of hypertension, obesity, diabetes mellitus and chronic kidney disease.
Is hyperuricemia a risk factor for chronic kidney disease?
Today there is plausible evidence both on experimental and epidemiological basis, that hyperuricemia represents a risk factor for the development and progression of chronic kidney disease (CKD). Nevertheless, the role of serum uric acid lowering treatment in CKD is still a matter of serious controversy.
What does hyperuricemia mean in gout?
In line with the consensus gout labels 11, hyperuricemia represents the elevated circulating levels of urate of 7 mg/dl in men and 6 mg/dl in women. Asymptomatic hyperuricemia is defined as elevated urate levels in absence of episodes of inflammation triggered by urate crystals (gout flares).
Does a low-purine diet affect NKG2D+ NK cells in hyperuricemia?
Gao L et al. Male asymptomatic hyperuricemia patients display a lower number of NKG2D+ NK cells before and after a low-purine diet. Medicine (Baltimore) 97, e13668, doi:10.1097/MD.0000000000013668 (2018).