From the Guidelines
Elevated uric acid levels are primarily caused by a combination of dietary factors, medical conditions, and certain medications, with the most significant risk factors including chronic kidney disease, overweight, and consumption of excess alcohol, as well as diuretic use and a diet rich in meat, seafood, and high-fructose foods or drinks. The causes of elevated uric acid can be broken down into several key categories:
- Dietary factors: excessive consumption of purine-rich foods like red meat, organ meats, seafood, and alcoholic beverages, particularly beer, as well as non-diet sodas and high-fructose foods or drinks 1
- Medical conditions: obesity, metabolic syndrome, diabetes, kidney disease, and hypothyroidism, with chronic kidney disease being a significant risk factor for chronic hyperuricaemia 1
- Medications: diuretics (especially thiazides like hydrochlorothiazide), low-dose aspirin, niacin, and some immunosuppressants, such as cyclosporine and tacrolimus 1
- Genetic factors: inherited metabolic disorders like Lesch-Nyhan syndrome causing overproduction of uric acid
- Other factors: rapid cell turnover conditions like psoriasis, cancer treatments, and tumor lysis syndrome, as well as dehydration and excessive exercise, which can temporarily increase uric acid levels due to tissue breakdown. Understanding these causes is crucial, as persistent hyperuricemia can lead to gout attacks, kidney stones, and chronic kidney disease if left untreated, and identifying person-specific risk factors for hyperuricaemia is essential for effective management, as some of these risk factors are modifiable 1.
From the FDA Drug Label
Hyperuricemia may be primary, as in gout, or secondary to diseases such as acute and chronic leukemia, polycythemia vera, multiple myeloma, and psoriasis It may occur with the use of diuretic agents, during renal dialysis, in the presence of renal damage, during starvation or reducing diets, and in the treatment of neoplastic disease where rapid resolution of tissue masses may occur. The causes of elevated uric acid include:
- Primary hyperuricemia, as in gout
- Secondary hyperuricemia due to diseases such as:
- Acute and chronic leukemia
- Polycythemia vera
- Multiple myeloma
- Psoriasis
- Use of diuretic agents
- Renal dialysis
- Renal damage
- Starvation or reducing diets
- Treatment of neoplastic disease with rapid resolution of tissue masses 2
From the Research
Causes of Elevated Uric Acid
- Elevated uric acid levels can be caused by various factors, including diet, genetics, and certain medical conditions 3, 4.
- Hyperuricemia, or elevated uric acid levels, can lead to the development of gout, a common inflammatory arthritis 5, 6.
- Uric acid levels can be influenced by the deposition of urate crystals, which can be affected by factors such as renal function and dietary intake 5, 3.
- Certain medications, such as allopurinol and febuxostat, can help reduce uric acid levels by inhibiting xanthine oxidase, an enzyme involved in uric acid production 5, 6.
- Lifestyle modifications, including dietary changes and weight loss, can also help manage hyperuricemia and reduce the risk of gout and other related conditions 3, 7.
Related Conditions
- Gout is a common condition associated with elevated uric acid levels, characterized by arthritis and inflammation 5, 6.
- Hyperuricemia has also been linked to an increased risk of cardiovascular and renal disease, although the exact mechanisms are not fully understood 4, 7.
- Certain medical conditions, such as hypertension, hyperlipidemia, and diabetes mellitus, are common comorbidities in patients with gout and hyperuricemia 6.
Management and Treatment
- Uric acid-lowering therapy (ULT) is a common treatment approach for managing hyperuricemia and gout, and can involve medications such as allopurinol and febuxostat 5, 6.
- Dietary and lifestyle modifications are also important for managing hyperuricemia and reducing the risk of related conditions 3, 7.
- Further research is needed to fully understand the role of uric acid in human health and disease, and to develop effective strategies for managing hyperuricemia and related conditions 4, 7.