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 Chen Xie
Endocrinology
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Treatment of Hyperuricemia with Medication

The treatment of hyperuricemia primarily involves dietary control, focusing on low-purine foods, increasing water intake, and maintaining regular exercise. Additionally, alkalizing the urine using sodium bicarbonate to keep the urine pH between 6.2 and 6.9 can help facilitate the excretion of uric acid. It's also important to avoid medications that can increase uric acid levels. For reducing uric acid, treatments mainly include probenecid, which can increase the excretion of uric acid, and febuxostat, an alternative to allopurinol, though side effects of these medications should be noted. Therefore, it is advised for patients with hyperuricemia to consult a doctor at a reputable hospital before taking any medications.

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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 Lin Xiang Dong
Endocrinology
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Hyperuricemia manifestations

Most cases of hyperuricemia usually have no obvious clinical symptoms, and it can take years to decades from the increase in blood uric acid to symptom onset, with some individuals never exhibiting obvious clinical symptoms throughout their lifetime. However, as age increases, the incidence of gout becomes higher. When accompanied by acute gouty arthritis, patients may experience severe joint pain. If blood uric acid levels remain high over a long period, this can lead to the formation of gouty tophi and uric acid stones, among other issues.

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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.