Asymptomatic Hyperuricemia: The Case for Conservative Management

Abstract

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 suggests that the risks of asymptomatic hyperuricemia are small or unknown and the efficiency of long-term 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 were offered.