ASYMPTOMATIC HYPER-URICEMIA - CASE FOR CONSERVATIVE MANAGEMENT

The management of asymptomatic hyperuricemia is controversial. Reported benefits from treatment include prevention of acute gouty arthritis, chronic tophaceous gout, urolithiasis, or gouty nephropathy. A review of experimental and clinical data suggest that the risks of asymptomatic hyperuricemia are small or unknown and the efficacy of longterm treatment in preventing gout or renal disease is unproved. The costs and risks of prolonged drug administration and practical considerations such as patient compliance mitigate against long-term therapy in asymptomatic persons. Some recommendations for an expectant approach to the management of asymptomatic hyperuricemia is offered.