Hyperuricemia standards

Written by Lin Xiang Dong

Endocrinology

Updated on September 15, 2024

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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 Li Hui Zhi

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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.

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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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Hyperuricemia Complications

Common complications, the first is the effect on joints, manifested as local joint redness, swelling, heat, and pain, and even mobility impairment, usually referring to gouty arthritis. The second complication is the effect on the kidneys, resulting in hyperuricemic nephropathy, where the patient will experience abnormal kidney function. The third complication is the formation of gouty tophi, where many patients have deposits in the joints, leading to the occurrence of tophi and causing joint mobility impairment. Therefore, hyperuricemia needs to be treated promptly to prevent these complications.

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Written by Chen Xie

Endocrinology

1min 9sec

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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 Chen Xie

Endocrinology

1min 8sec

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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.