Pre-symptomatic hyperuricemia

Written by Zhang Jun Jun
Endocrinology
Updated on October 28, 2024
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Hyperuricemia in the preclinical phase can be asymptomatic, only showing fluctuating or persistent hyperuricemia during blood tests. From the increase in uric acid to the onset of symptoms, it can generally take several years to decades. Additionally, some changes in the kidneys due to the deposition of uric acid can cause manifestations of gouty nephropathy. Early stages may present intermittent proteinuria and increased urine foam. As the condition progresses, the kidney's concentrating ability may decrease, resulting in increased nighttime urination. Further progression can lead to renal insufficiency, elevated creatinine and urea nitrogen, and possibly swelling and hypertension. In severe cases, acute renal failure may occur, showing symptoms of oliguria or anuria. This type of uric acid nephropathy is primarily due to the deposition in the kidneys, causing episodes of kidney stones and back pain, with stone episodes also accompanied by hematuria. Therefore, the main presentations are associated with the deposition of uric acid in the kidneys during the preclinical phase of hyperuricemia.

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Written by Luo Juan
Endocrinology
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What fruits to eat for hyperuricemia?

For patients with hyperuricemia, we generally need to limit the intake of high-purine foods, such as crab and animal offal. Moderate consumption of medium-purine foods, such as meats and fish, is acceptable. Low-purine foods like vegetables, fruits, milk, and eggs can be safely consumed. For example, fruits like grapes, pears, grapefruits, kiwis, and dragon fruits are all acceptable to eat. However, many patients with hyperuricemia also have other metabolic abnormalities, such as high blood sugar. In such cases, it is important to monitor the quantity of fruit intake because excessive consumption can lead to fluctuations in blood sugar levels. Therefore, fruits can be safely consumed by those with hyperuricemia, but attention must be paid to any additional metabolic abnormalities that may be present.

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Written by Li Hui Zhi
Endocrinology
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Is hyperuricemia dangerous?

Hyperuricemia is generally diagnosed when the blood uric acid level in males exceeds 420 micromoles per liter and in females exceeds 360 micromoles per liter. Some patients with hyperuricemia are asymptomatic, but others may develop gouty arthritis, characterized by local joint redness, swelling, heat, and pain, and even limited mobility. Some patients may develop gouty nephropathy, leading to abnormal kidney function. There are also instances of patients developing tophi, which can cause joint deformity and even limited mobility. Therefore, if hyperuricemia is not controlled promptly, it poses certain risks and may lead to complications such as tophi, gouty arthritis, and gouty nephropathy.

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Written by Chen Xie
Endocrinology
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What is contraindicated for hyperuricemia?

Hyperuricemia contraindications include the following points: 1. Strictly limit the intake of purines, restrict foods that contain more purines, including animal organs, bone marrow, seafood, fermented foods, beans, etc. 2. Reduce the intake of fats, as fats can decrease the excretion of uric acid. 3. Avoid high-protein foods, such as lean meat, chicken, and duck, which should be boiled and the broth discarded before consumption to avoid eating stewed or marinated meats. 4. Abstain from alcohol, as alcohol can lead to the accumulation of lactate in the body and inhibit the excretion of uric acid, easily triggering gout attacks. 5. Avoid hot pot, as the main ingredients in hot pot are animal organs, shrimp, shellfish, and seafood, and drinking beer with it can aggravate the condition, making these items contraindications for hyperuricemia.

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Written by Li Hui Zhi
Endocrinology
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What foods to eat for hyperuricemia?

Dietary requirements for hyperuricemia primarily include a low-purine diet, avoiding foods high in purines. It's important to recognize which foods are high in purines, such as seafood and certain fish, which should be avoided. Secondly, some mushrooms and soy products also have higher levels of purines and should be consumed less frequently. Thirdly, alcohol, especially spirits and beer, must be avoided. Fourthly, one should avoid consuming rich, slow-cooked broths as they also contain high levels of purines. Lastly, it is recommended to drink more water, typically between 1500ml to 2000ml daily.

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Written by Lin Xiang Dong
Endocrinology
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Causes of hyperuricemia

Hyperuricemia is divided into primary hyperuricemia and secondary hyperuricemia. Primary hyperuricemia is mainly due to a disorder in the metabolism of purines in the body, leading to excessive production of uric acid, which in turn causes hyperuricemia. Prolonged duration can greatly increase the risk of gout. Secondary hyperuricemia refers to hyperuricemia caused by excessive production or excretion obstacles due to some common diseases, the most common being chronic renal failure or some tumors, etc.