Table 1. Important Conditions and Comorbidities to Consider
When Evaluating Patients with Gout (C)
Common comorbid medical conditions to consider:
Metabolic syndrome:
Diabetes mellitus type 2, hypertension, hyperlipidemia, obesity
History of urolithiasis
Important conditions that directly impact serum urate levels:
Dietary factors (See Figure 3)
Excessive alcohol intake (See Figure 3)
Chronic kidney disease (CKD)
Serum urate-elevating medications
a
:
Niacin for hyperlipidemia
iazide and loop diuretics for hypertension, so long as cessation of treatment
would not exacerbate difficult-to-control hypertension cases
Calcineurin inhibition with cyclosporine or tacrolimus so long as other
satisfactory immune suppression agent is available
In selected cases, potential genetic or acquired cause of uric acid overproduction
(e.g., inborn error of purine metabolism or psoriasis, myeloproliferative, or
lymphoproliferative disease, respectively)
Lead intoxication
a
Examples of serum urate-elevating drugs that might be non-essential in a given patient and
potentially replaced by alternative agents that do not elevate serum urate.
