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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Pre-symptomatic hyperuricemia

Hyperuricemia in the preclinical phase can be asymptomatic, only showing fluctuating or persistent hyperuricemia during blood tests. From the increase in uric acid to the onset of symptoms, it can generally take several years to decades. Additionally, some changes in the kidneys due to the deposition of uric acid can cause manifestations of gouty nephropathy. Early stages may present intermittent proteinuria and increased urine foam. As the condition progresses, the kidney's concentrating ability may decrease, resulting in increased nighttime urination. Further progression can lead to renal insufficiency, elevated creatinine and urea nitrogen, and possibly swelling and hypertension. In severe cases, acute renal failure may occur, showing symptoms of oliguria or anuria. This type of uric acid nephropathy is primarily due to the deposition in the kidneys, causing episodes of kidney stones and back pain, with stone episodes also accompanied by hematuria. Therefore, the main presentations are associated with the deposition of uric acid in the kidneys during the preclinical phase of hyperuricemia.

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Written by Li Hui Zhi

Endocrinology

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Hyperuricemia Clinical Symptoms

Some patients with hyperuricemia may not have any symptoms, and only discover elevated uric acid levels during a physical examination. However, some patients may experience gouty arthritis, manifesting as redness, swelling, heat, and pain in a localized joint, commonly in the joints of the toes. It may also affect joints like the ankle and elbow. Additionally, some patients may develop gouty nephropathy, leading to renal insufficiency. Therefore, hyperuricemia should be taken seriously to prevent severe conditions such as gouty arthritis and other serious symptoms associated with gout.

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Written by Li Hui Zhi

Endocrinology

59sec

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Is hyperuricemia dangerous?

Hyperuricemia is generally diagnosed when the blood uric acid level in males exceeds 420 micromoles per liter and in females exceeds 360 micromoles per liter. Some patients with hyperuricemia are asymptomatic, but others may develop gouty arthritis, characterized by local joint redness, swelling, heat, and pain, and even limited mobility. Some patients may develop gouty nephropathy, leading to abnormal kidney function. There are also instances of patients developing tophi, which can cause joint deformity and even limited mobility. Therefore, if hyperuricemia is not controlled promptly, it poses certain risks and may lead to complications such as tophi, gouty arthritis, and gouty nephropathy.

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Written by Luo Juan

Endocrinology

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Hyperuricemia treatment agent

Currently, the main treatments for hyperuricemia in clinical practice include the following types. One category is drugs that inhibit uric acid synthesis, primarily allopurinol and febuxostat. Allopurinol is a xanthine oxidase inhibitor, which mainly works by preventing the conversion of hypoxanthine and xanthine into uric acid through the inhibition of xanthine oxidase. Febuxostat, on the other hand, is a newer xanthine oxidase inhibitor and may be more effective than allopurinol in lowering blood uric acid levels. Another category includes drugs that promote the excretion of uric acid, suitable for patients with normal renal function and hyperuricemia. These mainly include probenecid, benzbromarone, and some use of thiazide diuretics, though their effectiveness for hyperuricemia is somewhat controversial. (Specific medications should be taken under the guidance of a physician.)

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Written by Li Hui Zhi

Endocrinology

49sec

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Hyperuricemia and Its Complications

Hyperuricemia mainly refers to the elevation of uric acid levels in the blood, with levels exceeding 420 umol/l in males and 360 umol/l in females being diagnostic criteria. Some patients with hyperuricemia may not show symptoms, but if not controlled, complications can arise such as gouty arthritis, which manifests as local joint redness, swelling, heat, and pain, and even limited mobility. If it affects the kidneys, it leads to gouty kidney, which is characterized by abnormal kidney function and elevated creatinine levels. Therefore, if diagnosed with hyperuricemia, it is advisable to control diet, drink plenty of water, and seek timely medical treatment.