How does high uric acid damage the kidney?

In normal purine diet, male > 420umol/L, women > 360umol/L, is hyperuricemia. Hyperuricemia is closely related to hypertension, metabolic syndrome, kidney disease, diabetes and so on. So how does hyperuricemia damage the kidneys?
Direct damage
The uric acid level is too high, which exceeds the normal excretion capacity of the kidney, which results in a large amount of uric acid deposition in the renal tubule and renal interstitium, which causes the renal material damage.
How does high uric acid damage the kidney?
In addition, uric acid stones formed by hyperuricemia can also induce obstruction and obstruction related complications, and direct injury to the kidneys.
Indirect damage
High uric acid levels can increase blood viscosity and cause abnormal function of endothelial cells, which can lead to hypertension and vascular disease.
Hyperuricemia can directly or indirectly activate the RAS system, reduce the function of the renal tubular endothelial cells, and eventually develop terminal lesions such as kidney failure.
High uric acid associated with hyperglycemia, obesity, dyslipidemia, hypertension and insulin resistance can aggravate renal burden and CKD progression.
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