Table 1.

Secondary causes of hyperuricemia that should be considered in individuals with low risk for gout.

Acquired

  • Increased nucleic acid turnover: leukemia, myeloma, radiotherapy, chemotherapy (tumor lysis syndrome)

  • Altered ATP metabolism: alcohol abuse, excess fructose intake

  • Enhanced tubular secretion or reabsorption of uric acid: dehydration, starvation, insulin resistance, competitive organic ions (lactate, acetoacetate)

  • Drugs/toxins: salicylate, thiazide diuretics, lead poisoning

  • Comorbidities: chronic kidney disease, obesity, hypertension

Genetic

  • Inherited metabolic disorders: Lesch-Nyhan Syndrome, glycogen storage disease

  • Renal insufficiency because of genetic kidney defects: Gitelman syndrome, Bartter syndrome