Uric acid, endothelial dysfunction and pre-eclampsia: searching for a pathogenetic link

Background Pre-eclampsia is strongly associated with hyperuricemia, and in some studies the increase in serum uric acid has been found to correlate with both maternal and fetal morbidity. The hyperuricemia is believed to result primarily from the decreased renal excretion that occurs as a consequence of the pre-eclampsia, and as such is widely viewed as a marker for pre-eclampsia as opposed to having a role in the pathogenesis. Hypothesis We present the hypothesis that hyperuricemia may also have a contributory role in the development of hypertension and renal disease in these patients, and we review recent experimental data that would support this hypothesis. Recommendation We suggest that studies addressing the role of uric acid in pre-eclampsia may provide new insights into both the pathogenesis and treatment of this condition. (C) 2004 Lippincott Williams Wilkins.