Hyperuricemia Clinical Symptoms

Written by Li Hui Zhi
Endocrinology
Updated on September 02, 2024
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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
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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.

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Written by Li Hui Zhi
Endocrinology
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Dietary Guidance for Hyperuricemia

For hyperuricemia, it is generally recommended to adopt a low-calorie diet, control weight, and try to maintain an ideal weight. Secondly, avoid high-purine foods and opt for a diet low in purines. The third point encourages the use of some alkaline medications and strict abstinence from alcohol. The fourth point is to reduce the intake of fructose-rich beverages. The fifth point is to avoid drinking strong tea, coffee, cocoa, and other such beverages. The sixth point emphasizes the need to drink more water, recommending a daily water intake of at least 2000 milliliters.

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Written by Chen Xie
Endocrinology
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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 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
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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.