Is hyperuricemia serious?

Written by Zhang Jun Jun
Endocrinology
Updated on May 06, 2025
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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.

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Written by Luo Juan
Endocrinology
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Is hyperuricemia contagious?

Hyperuricemia is not contagious. Hyperuricemia refers to a condition where the concentration of uric acid in the blood exceeds the normal upper limit. Typically, for males and post-menopausal females, a blood uric acid concentration greater than 420 µmol/L, or pre-menopausal females with more than 348 µmol/L, is considered hyperuricemia. Most severe cases of hyperuricemia are due to deficiencies in uric acid metabolism enzymes and fall under the category of liver metabolism disorders. Moreover, mild to moderate hyperuricemia is often associated with obesity, type 2 diabetes, hyperlipidemia, hypertension, arteriosclerosis, and coronary heart disease, among others. It is a type of nucleic acid metabolic disease, and therefore, it is not contagious.

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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 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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The causes of hyperuricemia

The causes of hyperuricemia can currently be divided into two categories: primary and secondary. The cause of most primary hyperuricemia is not yet clear. A few cases are due to enzyme deficiencies, which are related to either excessive production or reduced excretion of uric acid. There is also idiopathic hyperuricemia, such as familial kidney diseases that are associated with hyperuricemia, among others. Some secondary hyperuricemias, for example, are secondary to some congenital metabolic diseases, such as glycogen storage disease. It can also be due to certain systemic diseases, such as leukemia, multiple myeloma, lymphoma, polycythemia vera, hemolytic anemia, etc. Some cases are physiological increases, such as the intake of foods rich in purines, long-term eating and fasting states can also cause increased blood uric acid. Some medications can also lead to hyperuricemia, such as thiazide diuretics, furosemide, ethanol, immunosuppressants, aspirin, etc., which can also cause hyperuricemia. Therefore, the causes of hyperuricemia are diverse, and some causes are still unclear.

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

Foods to avoid for hyperuricemia include those high in purines. Here is a list of foods that are high in purines: 1. Seafood, such as some shellfish, shrimp, crab, and certain fishes. 2. Broths that have been simmered for a long time, as they tend to contain higher levels of purines. 3. Certain mushrooms should be consumed less, such as shiitake and straw mushrooms. 4. Animal organs should be avoided as much as possible. 5. Alcohol, especially strong spirits and beer, should be avoided; instead, it's important to drink plenty of water, ensuring to consume 1500 to 2000 milliliters daily.