Abstract The inherited disorders of purine metabolism associated with renal disease are listed in Table 24.1. They are the sole cause of only a small proportion of all renal disease and are therefore best considered as part of the overall problem of purine, especially uric acid metabolism-related renal disease. Genetic factors may precipitate the occurrence or determine the severity of acquired disorders in this area. Conversely, environmental factors and acquired diseases modify the phenotypic expression of the primary genetic conditions.