Tratamiento de las hiperuricemias

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Paula Iscoff
Carolina Paradiso
Guillermo A. De Marziani
Alicia Ester Elbert

Resumen

El manejo de la hiperuricemia (HU) asintomática y los trastornos asociados al ácido úrico (AU) difieren de acuerdo al contexto clínico del paciente y/o al estadio de la enfermedad renal (ER). Existe una asociación entre los niveles de AU y la hipertensión arterial (HTA), la edad, la enfermedad cardiovascular (ECV) y ER. La causalidad de esta relación es aún hoy un tema controversial, así como el rol del AU en la iniciación, progresión y desarrollo de la ER y en el trasplante. Las modalidades farmacológicas empleadas en el tratamiento de las alteraciones del AU pueden clasificarse según su efecto antiinflamatorio en el ataque agudo, profiláctico para evitar recurrencia o considerar las drogas hipouricemiantes para prevenir o revertir las complicaciones generadas por depósitos de cristales de urato en articulaciones (artropatía gotosa), tracto urinario (litiasis, nefritis tubulointersticial) y tejidos (tofos). Es vital que los valores plasmáticos de uratos sean mantenidos por debajo de 6.8 mg/dl, un nivel por encima del cual podría precipitar; niveles bajos se relacionan a mejor evolución en pacientes con gota, incluyendo menores ataques, mayor rapidez en reducción del tamaño de los tofos y desaparición de cristales de urato monosódico en líquido sinovial.

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1.
Iscoff P, Paradiso C, De Marziani GA, Elbert AE. Tratamiento de las hiperuricemias. Rev Nefrol Dial Traspl. [Internet]. 17 de junio de 2017 [citado 27 de octubre de 2021];37(2):104-1. Disponible en: https://www.revistarenal.org.ar/index.php/rndt/article/view/143
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