[Uric acid and kidneys – Physiological and pathophysiological aspects].

Kidneys play a critical role in the excretion of uric acid. Improved knowledge of the renal tubular uric acid transport mechanisms helps to better understand, why hyper- or hypouricemia can develop without the external influence of purine intake. Besides the genetic mutations, several drugs and specific medical conditions can significantly influence the tubular excretion of uric acid and thus the serum uric acid level. It seems evident that the renal function per se has a relevant impact on the uric acid excretion. It is however not clear, whether uric acid has a causal role in the development of chronic kidney disease and if so, to what extent. In order to better understand the impact of hyper- and hypouricemia and especially their clinical relevance, further researches on the renal tubular physio- and pathophysiology and also high quality intervention studies are required.