Consult Rounds: High Uric Acid

Uric acid elevations are frequently noted in patients with renal insufficiency as a clearance related problem.
We also note seriously high uric acid levels in patients with tumor lysis syndromes or large tumor burdens.
HCTZ can also do it.


What about tissue hypxia? Changes in oxygen tension has been associated with modulation of purine turnover.  
Rat and human studies have shown that uric acid levels in hypoxia are much higher than normoxia and hyperoxia.  There is a correlation that hypoxia results in greater purine catabolism and leading to increased production of uric acid. Hence we often see lactate levels correlating well with uric acid levels in sepsis.

Few ref:
http://www.ncbi.nlm.nih.gov/pubmed/8470901
http://www.ncbi.nlm.nih.gov/pubmed/20730463
http://www.ncbi.nlm.nih.gov/pubmed/17067515
http://www.ncbi.nlm.nih.gov/pubmed/17269363