Asymptomatic hyperuricaemia is the 1st stage of gout in which the serum urate levels are raised.
Chronic tophaceous gout is caused by the formation of solid urate deposits--tophi--in the connective tissues, predominately of the fingers, toes, elbows and ears.
(10) In this study of 5,707 participants in the 2007-2008 NHANES, 74% had HTN, 71% had CKD stage 2 or higher, 53% were obese, 26% had diabetes, 24% had nephrolithiasis, 14% had myocardial infarction, 11% had heart failure, and 10% had suffered a stroke; the prevalence of these comorbidities were also noted to increase with the degree of hyperuricemia, supporting the notion that serum urate
is related to the presence of several gout comorbidities, either as a marker of disease or perhaps by itself exacerbating other diseases.
Results showed that the prevalence of gout, hyperuricemia, and high serum urate
levels all significantly increased during the past 2 decades.
The chemistry of urates
becomes more complicated once excreted by the kidneys.
The presence of monosodium urate
monohydrate crystals in synovial fluid remains the gold standard for gout diagnosis, with a sensitivity of 84% and a specificity of 100%, according to new gout diagnostic guidelines issued by the European League Against Rheumatism.
If a 24-hour urine specimen is to be used for quantitative urate
determination, NCCLS Document GP13-P does indeed state that the specimen should not be refrigerated.
The above studies link meat and seafood, but not protein or dairy, to high serum urate
In theory, joints and synovial sheaths are target sites for urate
deposits because the temperature is lower in these tissues than in the rest of the body, thereby lowering the solubility of sodium urate
For example, they demonstrated that the adjuvant effect of the putative urate
fraction was abrogated by the addition of uricase.
There were no significant differences in age, uric acid levels in urine, or serum urate
levels at the beginning of the treatment (Table 2).
Of the remaining stone categories, urate
or purine stones are the most common.