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Decreased glomerular filtration, as well as the effects on tubular handling of uric acid of hydration, certain organic acids, drugs (in particular thiazide and loop diuretics) and exogenous toxins (e.g., lead), all impair renal excretion of uric acid ( Table 1 - 3 )

However, the intensity of remote medicine also sparked a desire for specialized training, leading him to pursue an emergency medicine residency at Emory University in Atlanta