Arthritis in the intensive care unit

Raj, Jaya; Sudhakar, Sheila; Sems, Kelly M.; Carlson, Richard W.

doi:10.1016/s0749-0704(02)00021-0

Cited by 3 publications

(1 citation statement)

References 51 publications

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“…The postoperative state 41 Critical illness with metabolic acidosis 42 Sarcoidosis 43 Hyperparathyroidism 44 Ketosis 45 Polycystic kidney disease 46 Down syndrome 47 Hypoxanthine-guanine phosphoribosyl-transferase deficiency (Lesch-Nyhan syndrome when homozygous) 48 Phosphoribosylpyrophosphate synthetase overactivity 49 Glucose-6-phosphatase deficiency (von Gierke's disease) 49 Fructose 1-phosphate aldolase deficiency 50 argues that increased dietary fructose and salt are additive in their effects, and optimal blood pressure control for the hypertensive population would require reduction of both nutrients.…”

Section: Dehydrationmentioning

confidence: 99%

New and improved strategies for the treatment of gout

Dubchak¹,

Falasca²

2010

IJNRD

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The Western world appears to be in the midst of the third great gout epidemic of all time. In this century, gout is increasing in prevalence despite an increased understanding of its risk factors and pathophysiology, and the availability of reasonably effective treatment. The main cultural factors responsible for this appear to be diet, obesity, ethanol use and medications. Excess fructose consumption is a newly recognized modifiable risk factor. The debate has been renewed concerning hyperuricemia as an independent risk factor for renal insufficiency and cardiovascular disease. Prevention is still rooted in lifestyle choices. Existing treatments have proven to be unsatisfactory in many patients with comorbidities. New treatments are available today and on the horizon for tomorrow, which offer a better quality of life for gout sufferers. These include febuxostat, a nonpurine inhibitor of xanthine oxidase with a potentially better combination of efficacy and safety than allopurinol, and investigational inhibitors of URAT-1, an anion exchanger in the proximal tubule that is critical for uric acid homeostasis. New abortive treatments include interleukin-1 antagonists that can cut short the acute attack in 1 to 2 days in persons who cannot take nonsteroidal anti-inflammatory drugs, colchicine or corticosteroids. Lastly, newer formulations of uricase have the ability to dissolve destructive tophi over weeks or months in patients who cannot use currently available hypouricemic agents. Diagnostically, ultrasound and magnetic resonance imaging offer advanced ways to diagnose gout noninvasively, and just as importantly, a way to follow the progress of tophus dissolution. The close association of hyperuricemia with metabolic syndrome, hypertension and renal insufficiency ensures that nephrologists will see increasing numbers of gout-afflicted patients.

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