Hyperuricemia occurs frequently in PHPT. Auerbach and associates5 showed that 22 (32%) of 56 patients had uric acid concentrations greater than 7 mg/dL. Postoperatively, there was no significant change in 6 patients (27%). In 14 patients (64%), the serum level fell by more than 1 mg/dL.79 Duh and colleagues17 reported similar findings in a larger group of patients. An increased concentration of urate in PHPT has been described by several authors.17,128129 Valdemarsson and coworkers120 found a significant decrease of serum urate among men and women 1 year after successful surgery for PHPT. Furthermore, they showed a significant correlation between ionized calcium and intact PTH and urate, indicating an influence of PTH on urate metabolism. In a further study, Westerdahl and associates130

found urate to be an independent risk factor for the presence of clinically relevant atherosclerotic disease in patients with PHPT.

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