Hyperuricemia

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Written by Li Hui Zhi
Endocrinology
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Symptoms of hyperuricemia

Hyperuricemia, some people are asymptomatic, while others may present various symptoms. Commonly, it first affects the joints, resulting in gouty arthritis, characterized by local joint redness, swelling, heat, and pain. This most frequently involves the metatarsophalangeal joints of the feet, as well as the ankle and wrist joints. Secondly, gout can lead to gouty nephropathy, accompanied by renal insufficiency. Thirdly, it can cause gouty rheumatism, leading to joint mobility impairment. Therefore, it is essential to prevent hyperuricemia in a timely manner to avoid complications such as gouty arthritis, gouty nephropathy, and gouty rheumatism.

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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.

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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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Hyperuricemia standards

The diagnostic criteria for hyperuricemia specify that under normal purine diet conditions, if the fasting serum uric acid level on non-consecutive days exceeds 420 micromoles/liter for males and 360 micromoles/liter for females, hyperuricemia can be diagnosed. Hyperuricemia is typically classified into primary hyperuricemia and secondary hyperuricemia, with most patients showing no clear clinical symptoms.

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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 Li Hui Zhi
Endocrinology
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What are the harms of hyperuricemia?

What are the dangers of hyperuricemia? First, it primarily causes gouty arthritis, characterized by redness, swelling, heat, and pain in certain joints, along with limited movement. For some people, the pain can be extremely unbearable. Second, long-term high levels of uric acid can damage the kidneys, leading to impaired kidney function. Third, these purines deposit in the joints forming gout stones, further affecting the function of these joints and reducing the quality of life. Therefore, it is important to treat hyperuricemia early to prevent complications.

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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 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 Lin Xiang Dong
Endocrinology
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Hyperuricemia Typing

Hyperuricemia can usually be divided into two types: primary hyperuricemia and secondary hyperuricemia. The first type, primary hyperuricemia, is mainly due to congenital purine metabolic disorders, leading to excessive production of uric acid in the body, which then causes hyperuricemia. Secondary hyperuricemia is caused by a variety of acute and chronic diseases, such as common chronic renal failure, and hematological tumors, among others.

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Written by Chen Xie
Endocrinology
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How is hyperuricemia treated?

The treatment of hyperuricemia mainly includes: First, improving lifestyle, including healthy eating with a low-purine diet, quitting smoking, drinking more water, exercising regularly, and controlling weight. Second, alkalinizing the urine using sodium bicarbonate to maintain urine pH between 6.2 and 6.9, which facilitates the excretion of uric acid. Third, avoiding medications that increase blood uric acid levels, such as diuretics, corticosteroids, and insulin, among others. Fourth, using medications that lower uric acid, including drugs that increase uric acid excretion, mainly benzbromarone and probenecid, and drugs that inhibit uric acid synthesis, such as allopurinol and febuxostat. The choice of medication has specific indications, contraindications, and side effects, and it is advised to use these medications under the guidance of a specialist and not to self-medicate.