What class of diuretics is known for causing hyperuricemia?

Thiazide diuretics are known for causing hyperuricemia due to their mechanism of action on the renal tubules. These agents work primarily in the distal convoluted tubule of the nephron, where they inhibit the reabsorption of sodium and chloride. This inhibition leads to increased urine output but also affects uric acid handling.

When thiazide diuretics are used, they can lead to the reabsorption of uric acid in the proximal tubule. As a result, there is an increase in uric acid levels in the blood, causing hyperuricemia. This condition can potentially trigger gout in predisposed individuals due to elevated serum uric acid levels.

In contrast, loop diuretics and osmotic diuretics have different mechanisms and generally do not lead to hyperuricemia to the same extent. Loop diuretics primarily affect the thick ascending limb of the loop of Henle, while osmotic diuretics work by increasing osmolarity in the nephron, promoting fluid retention in the tubules. Carbonic anhydrase inhibitors, on the other hand, influence bicarbonate reabsorption and are not typically associated with changes in uric acid levels.

Therefore, thiazide