Hyperuricemia standards

Written by Lin Xiang Dong

Endocrinology

Updated on September 15, 2024

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The diagnostic criteria for hyperuricemia specify that under normal purine diet conditions, if the fasting serum uric acid level on non-consecutive days exceeds 420 micromoles/liter for males and 360 micromoles/liter for females, hyperuricemia can be diagnosed. Hyperuricemia is typically classified into primary hyperuricemia and secondary hyperuricemia, with most patients showing no clear clinical symptoms.

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The causes of hyperuricemia

The causes of hyperuricemia can currently be divided into two categories: primary and secondary. The cause of most primary hyperuricemia is not yet clear. A few cases are due to enzyme deficiencies, which are related to either excessive production or reduced excretion of uric acid. There is also idiopathic hyperuricemia, such as familial kidney diseases that are associated with hyperuricemia, among others. Some secondary hyperuricemias, for example, are secondary to some congenital metabolic diseases, such as glycogen storage disease. It can also be due to certain systemic diseases, such as leukemia, multiple myeloma, lymphoma, polycythemia vera, hemolytic anemia, etc. Some cases are physiological increases, such as the intake of foods rich in purines, long-term eating and fasting states can also cause increased blood uric acid. Some medications can also lead to hyperuricemia, such as thiazide diuretics, furosemide, ethanol, immunosuppressants, aspirin, etc., which can also cause hyperuricemia. Therefore, the causes of hyperuricemia are diverse, and some causes are still unclear.

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What should be avoided with hyperuricemia?

Foods to avoid for hyperuricemia include those high in purines. Here is a list of foods that are high in purines: 1. Seafood, such as some shellfish, shrimp, crab, and certain fishes. 2. Broths that have been simmered for a long time, as they tend to contain higher levels of purines. 3. Certain mushrooms should be consumed less, such as shiitake and straw mushrooms. 4. Animal organs should be avoided as much as possible. 5. Alcohol, especially strong spirits and beer, should be avoided; instead, it's important to drink plenty of water, ensuring to consume 1500 to 2000 milliliters daily.

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Hyperuricemia Complications

Common complications, the first is the effect on joints, manifested as local joint redness, swelling, heat, and pain, and even mobility impairment, usually referring to gouty arthritis. The second complication is the effect on the kidneys, resulting in hyperuricemic nephropathy, where the patient will experience abnormal kidney function. The third complication is the formation of gouty tophi, where many patients have deposits in the joints, leading to the occurrence of tophi and causing joint mobility impairment. Therefore, hyperuricemia needs to be treated promptly to prevent these complications.

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What is contraindicated for hyperuricemia?

Hyperuricemia contraindications include the following points: 1. Strictly limit the intake of purines, restrict foods that contain more purines, including animal organs, bone marrow, seafood, fermented foods, beans, etc. 2. Reduce the intake of fats, as fats can decrease the excretion of uric acid. 3. Avoid high-protein foods, such as lean meat, chicken, and duck, which should be boiled and the broth discarded before consumption to avoid eating stewed or marinated meats. 4. Abstain from alcohol, as alcohol can lead to the accumulation of lactate in the body and inhibit the excretion of uric acid, easily triggering gout attacks. 5. Avoid hot pot, as the main ingredients in hot pot are animal organs, shrimp, shellfish, and seafood, and drinking beer with it can aggravate the condition, making these items contraindications for hyperuricemia.

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Symptoms of hyperuricemia

Hyperuricemia, some people are asymptomatic, while others may present various symptoms. Commonly, it first affects the joints, resulting in gouty arthritis, characterized by local joint redness, swelling, heat, and pain. This most frequently involves the metatarsophalangeal joints of the feet, as well as the ankle and wrist joints. Secondly, gout can lead to gouty nephropathy, accompanied by renal insufficiency. Thirdly, it can cause gouty rheumatism, leading to joint mobility impairment. Therefore, it is essential to prevent hyperuricemia in a timely manner to avoid complications such as gouty arthritis, gouty nephropathy, and gouty rheumatism.