musculoskeletal and connective tissue disorders
Gout
Asymptomatic Hyperuricemia
Asymptomatic hyperuricemia is elevation of serum urate > 7 mg/dL (> 0.4 mmol/L) in the absence of clinical gout. Generally, treatment of asymptomatic hyperuricemia is not required. Most patients with asymptomatic hyperuricemia with serum urate levels as high as 10 mg/dL (0.6 mmol/L) do not develop gout flares over 10 years. However, patients with overexcretion of urate and recurrent uric acid kidney stones despite urinary alkalinization and sufficient hydration may receiveallopurinol. Observational data suggested that hyperuricemia may contribute to the progression of chronic kidney disease, cardiovascular disease, and, in adolescents, primary hypertension. Interventional studies, however, have not demonstrated that lowering the serum urate level reduces progression of renal disease. 