Abstract
Hyperuricemia is caused by an imbalance between the rates of production and excretion of uric acid. The most common cause of hyperuricemia is decreased uric acid excretion in the kidneys.
Chronic hyperuricemia can lead to crystal formation and development of gout. Many studies have shown that gout and hyperuricemia are associated with other diseases, such as arterial hypertension, chronic renal failure, type 2 diabetes mellitus and ischemic heart disease.
In patients with gout, the treatment of chronic hyperuricemia is necessary to prevent gout attacks and development of tophi or to eliminate them. The most widely used drugs for hyperuricemia are xanthine oxidase inhibitors, which block the last enzyme involved in uric acid synthesis pathway.
Uricosuric agents experience renewed interest. Novel uricosurics, which inhibit specific urate transporters responsible for reabsorption of uric acid in renal proximal tubule, are under development.
Newer therapeutic strategies include e.g. pegylated recombinant uricase.