How is hyperuricemia treated?

Written by Chen Xie
Endocrinology
Updated on September 01, 2024
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The treatment of hyperuricemia mainly includes the following points: 1. Improve lifestyle primarily, including a low-purine diet, appropriate exercise, smoking cessation, and increased water intake. 2. Alkalize urine using sodium bicarbonate to maintain urine pH value between 6.2 and 6.9, which facilitates the excretion of uric acid. 3. Avoid drugs that increase uric acid levels, such as diuretics, corticosteroids, and insulin. 4. Use medications that lower uric acid levels; drugs that increase uric acid excretion mainly include probenecid and sulfinpyrazone, and drugs that inhibit uric acid synthesis mainly include febuxostat and allopurinol. However, the treatment with these drugs has specific indications, contraindications, and related side effects. It is advised to use medication under the guidance of a doctor and avoid choosing drugs for treatment arbitrarily.

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Written by Li Jing
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How is hyperuricemia caused?

Hyperuricemia is mostly asymptomatic, meaning there are no uncomfortable symptoms. It is usually discovered during physical examinations or blood tests when the uric acid level is found to be elevated, around 420, which is considered hyperuricemia. What causes it? It is mainly caused by poor lifestyle habits, such as long periods of drinking alcohol, excessive intake of animal organs, seafood, barbecue, and too much protein intake. Additionally, some people may develop high uric acid levels due to prolonged use of diuretics. When hyperuricemia occurs, it is essential to change lifestyle habits, but at this time, no special medication treatment is needed.

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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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Written by Li Hui Zhi
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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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Written by Li Hui Zhi
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What foods should be avoided with hyperuricemia?

Hyperuricemia generally requires a low-purine diet. So, what foods should be avoided? First, seafood and sea fish, as they have a high purine content and should not be consumed. Second, avoid animal organs like chicken and duck kidneys. Third, abstain from alcohol, especially strong spirits and beer, which tend to raise uric acid levels, so it's recommended to avoid them. Fourth, it is advised not to consume long-cooked broths, such as those commonly enjoyed in Guangdong where the broth is simmered for several hours, as these also have high purine content. Fifth, limit intake of some bean products and various mushrooms, as these should also be consumed minimally.

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Is hyperuricemia serious?

Hyperuricemia can be divided into several stages, each with varying degrees of severity. Early on, it may be asymptomatic, manifesting either as consistent or fluctuating hyperuricemia. If it progresses to an acute gout phase, it can cause a series of harms to the kidneys, joints, and internal organs. During the chronic gout phase, there is more deposition of urate salts, primarily affecting the kidneys. Initially, it causes gouty nephropathy, leading to edema, hypertension, renal insufficiency, and even acute renal failure. The second scenario involves uric acid-related kidney stone disease, which can lead to a significant number of kidney stones, causing acute renal failure, pyelonephritis, renal abscesses, and more. Additionally, it can cause eyelid lesions, including blepharitis along the eyelid margin, and possibly gouty tophi near the eyelid margin that may rupture, adversely affecting the eyes and vision. It may even lead to retinal hemorrhage, exudation, and edema. Thus, uncontrolled uric acid levels represent a serious health concern.