What is hyperuricemia?

Written by Chen Xie
Endocrinology
Updated on August 31, 2024
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Hyperuricemia refers to a condition where, under normal purine diet, fasting blood uric acid levels exceed 420 micromoles per liter in males and 360 micromoles per liter in females. Uric acid is the final metabolic product of human purine compounds. Disorders in purine metabolism lead to hyperuricemia, which is influenced by various factors including genetics, gender, age, lifestyle, dietary habits, medical treatments, and the level of economic development. Clinically, hyperuricemia can be classified into primary and secondary types. Common clinical manifestations mainly include gout, and possibly arthritis, which are closely related to hypertension, diabetes, hyperlipidemia, coronary heart disease, and renal impairment. Therefore, it is necessary to control hyperuricemia.

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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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Can hyperuricemia be cured?

Hyperuricemia is a metabolic disease caused by disorders in purine metabolism and is clinically divided into primary and secondary categories. Primary hyperuricemia is caused by congenital abnormalities in purine metabolism and is often associated with obesity, dyslipidemia, hypertension, atherosclerosis, and coronary heart disease. Secondary hyperuricemia, on the other hand, is caused by certain systemic diseases or medications. Therefore, whether hyperuricemia can be cured depends on the underlying condition, and the efficacy of treatment cannot be generalized. For hyperuricemia caused by medications or systemic diseases, it can be cured by treating the disease or discontinuing the medication. However, for hyperuricemia caused by congenital abnormalities in purine metabolism, it can be clinically managed by controlling diet and medication, but it is not curable.

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How should one with hyperuricemia adjust their diet?

For the diet of hyperuricemia, it is generally recommended to follow a low-purine diet. What is a low-purine diet? First, try to avoid consuming seafood, animal organs, and other seafood products that contain high purines. Second, it is advised to abstain from alcohol, especially spirits and beer, and it is best not to drink them at all. Third, drink plenty of water, ensuring a daily intake of at least 1500 to 2000 milliliters. Fourth, it is also recommended to avoid consuming traditional long-cooked soups and hotpots.

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What should be noted for hyperuricemia?

Firstly, hyperuricemia is just found during routine physical examinations or blood tests, showing an increase in blood uric acid levels without the occurrence of gout attacks, meaning there are no symptoms of joint pain. At this time, there is no need for special medication, which means uric acid-lowering drugs are not required. However, you need to be cautious and change your lifestyle habits. For example, abstaining from alcohol, controlling the intake of animal organs, seafood, and barbecued foods. Additionally, drinking more water is necessary, and for overweight individuals, controlling weight and losing weight are important considerations. Also, you should avoid intense physical activities as they can trigger gout attacks, but this doesn't mean no exercise at all; slow walking and swimming are fine.

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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.