Uric acid and renal disease

Uric acid is the end product of human purine metabolism and is largely removed by the kidney, The renal excretion of uric acid involves filtration, secretion, and reabsorption, Although the transcellular transport of uric acid by tubular cells is nor sodium dependent, excretion is affected significantly by the state of hydration of the extracellular fluid volume, Alterations in the plasma concentration of uric acid may result from renal injury, administration of drugs which affect the transport processes, or alterations in the extracellular fluid volume, In addition to these common clinical associations, three uric acid related renal disorders have been confirmed, Uric acid associated acute renal failure is characterized by massive overproduction and precipitation of uric acid in renal tubules, Uric acid neophrolithiasis involves precipitation of uric acid in the urinary collecting system, Chronic urate nephropathy (Gouty nephropathy) describes a syndrome of hyperuricemia, gouty arthritis, hypertension, and slowly progressive renal insufficiency, This review discusses the relationship between uric acid physiology and associated renal diseases with recommendations for therapy.