What is the causes of combined underexcretion and overproduction of uric acid in hyperuricemia?

Updated: Nov 03, 2020
  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Combined causes include the following:

  • Alcohol [7] : Ethanol increases the production of uric acid by causing increased turnover of adenine nucleotides. It also decreases uric acid excretion by the kidneys, which is partially due to the production of lactic acid.

  • Fructose-sweetened soft drinks: Fructose raises serum uric acid levels by accentuating degradation of purine nucleotides and increasing purine synthesis, and epidemiologic studies have documented a link between sugar-sweetened soft drink intake and serum uric acid levels in several populations. [15, 16, 17, 18]  More recently, Lecoultre et al found that fructose-induced hyperuricemia is associated with a decreased uric acid excretion by the kidneys. [19]

  • Exercise: Exercise may result in enhanced tissue breakdown and decreased kidney excretion due to mild volume depletion.

  • Deficiency of aldolase B (fructose-1-phosphate aldolase): This is a fairly common inherited disorder, often resulting in gout.

  • Glucose-6-phosphatase deficiency (glycogenosis type I, von Gierke disease): This is an autosomal recessive disorder characterized by the development of symptomatic hypoglycemia and hepatomegaly within the first 12 months of life. Additional findings include short stature, delayed adolescence, enlarged kidneys, hepatic adenoma, hyperuricemia, hyperlipidemia, and increased serum lactate levels.

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