Screening and Management of Hyperuricemia in Patients with Chronic Medical Diseases in Assiut University Hospital

Hyperuricemia is classically defined as a serum uric acid (SUA) of more than 7.0 mg/dL in men or more than 6.0 mg/dL in women . Asymptomatic hyperuricemia is a condition, where patients have elevated levels of SUA, yet do not exhibit symptoms or signs of monosodium urate crystal deposition, such as gout attacks, urolithiasis, or uric acid nephropathy . SUA can be elevated 10 to 15 years before clinical manifestations of gout . Up to 21% of the general population and 25% of hospitalized patients are estimated to have asymptomatic hyperuricemia .

Uric acid excretion mostly occurs via the kidneys, so decreased glomerular filtration rates in chronic kidney (CKD) patients contribute to the population increase in hyperuricemia. Conversely, studies suggest that hyperuricemia may contribute to CKD , raising the possibility that urate-lowering therapies (ULTs) could be useful in slowing CKD progression . There was no independent association between hyperuricemia and systemic arterial hypertension. Also, hyperuricemia has been reported as an independent risk factor for both coronary artery disease, congestive heart failure and diabetes mellitus.

So efforts should be made to recognize individuals at risk of hyperuricemia by evaluating dietary habits, family history, and lifestyle factors, and regularly monitor SUA levels. As well as, management strategies, including lifestyle modifications, pharmacotherapy, and dietary interventions, to effectively control SUA and reduce the risk of associated complications.

Inclusion criteria

• Patients 18 years of age or older who were diagnosed with chronic medical diseases as diabetes mellitus , hypertension , obesity , metabolic syndrome , chronic kidney disease and cardiovascular disease (ischemic cardiomyopathy, heart failure ,coronary arteries disease) .

Exclusion criteria

• patients under the age of 18.
• patients kown to have gouty arthritis
• patients with acute kidney disease .
• patients receiving thiazide diuretics.
• patients with tumour lysis syndrome .