Management of asymptomatic hyperuricemia

Although the incidence of gout, renal stones, or both is increased in patients with hyperuricemia, there is no evidence that long-term therapy offers any substantial long-term benefits. Recent data also suggest that no clear relationship exists between hyperuricemia and the development of interstitial nephritis (so-called urate nephropathy). Finally, the relationship between elevations in the serum concentration of uric acid and the risk of developing cardiovascular disease remains undefined. It is recommended that, in a patient with asymptomatic hyperuricemia, a conservative approach be taken and hypouricemic therapy not be instituted as a matter of routine.