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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How is hyperuricemia treated?

The treatment of hyperuricemia mainly includes the following points: 1. Improve lifestyle primarily, including a low-purine diet, appropriate exercise, smoking cessation, and increased water intake. 2. Alkalize urine using sodium bicarbonate to maintain urine pH value between 6.2 and 6.9, which facilitates the excretion of uric acid. 3. Avoid drugs that increase uric acid levels, such as diuretics, corticosteroids, and insulin. 4. Use medications that lower uric acid levels; drugs that increase uric acid excretion mainly include probenecid and sulfinpyrazone, and drugs that inhibit uric acid synthesis mainly include febuxostat and allopurinol. However, the treatment with these drugs has specific indications, contraindications, and related side effects. It is advised to use medication under the guidance of a doctor and avoid choosing drugs for treatment arbitrarily.

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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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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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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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Dietary Guidance for Hyperuricemia

For hyperuricemia, it is generally recommended to adopt a low-calorie diet, control weight, and try to maintain an ideal weight. Secondly, avoid high-purine foods and opt for a diet low in purines. The third point encourages the use of some alkaline medications and strict abstinence from alcohol. The fourth point is to reduce the intake of fructose-rich beverages. The fifth point is to avoid drinking strong tea, coffee, cocoa, and other such beverages. The sixth point emphasizes the need to drink more water, recommending a daily water intake of at least 2000 milliliters.