Treatment of Hyperuricemia with Medication

Written by Chen Xie
Endocrinology
Updated on September 14, 2024
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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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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 Li Jing
Rheumatology
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Are hyperuricemia and high uric acid the same thing?

Firstly, hyperuricemia and high uric acid levels refer to the same concept, defined as blood uric acid levels greater than 420. This condition is described as asymptomatic hyperuricemia, which does not require special treatment at this stage, but it does necessitate changes in lifestyle habits such as abstaining from alcohol, avoiding eating animal organs, seafood, and high-protein foods, not drinking carbonated beverages, and losing weight if obese, to help control body weight. After changing these lifestyle habits, a recheck of the uric acid levels should be done in two weeks to see if there has been a decrease. If the levels have not decreased at that time, sodium bicarbonate tablets can be used to alkalinize the urine. Additionally, increasing water intake to promote the excretion of uric acid and monitoring the dynamic changes in uric acid levels are needed. Once joint pain occurs, which indicates an acute gout attack, proper uric acid-lowering medication is required. (Please undergo medication under the guidance of a professional physician, and do not self-medicate blindly.)

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Written by Chen Xie
Endocrinology
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What is hyperuricemia?

Hyperuricemia refers to a condition where, under normal purine diet, fasting blood uric acid levels exceed 420 micromoles per liter in males and 360 micromoles per liter in females. Uric acid is the final metabolic product of human purine compounds. Disorders in purine metabolism lead to hyperuricemia, which is influenced by various factors including genetics, gender, age, lifestyle, dietary habits, medical treatments, and the level of economic development. Clinically, hyperuricemia can be classified into primary and secondary types. Common clinical manifestations mainly include gout, and possibly arthritis, which are closely related to hypertension, diabetes, hyperlipidemia, coronary heart disease, and renal impairment. Therefore, it is necessary to control hyperuricemia.

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Written by Li Hui Zhi
Endocrinology
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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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Written by Li Hui Zhi
Endocrinology
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What are the symptoms of hyperuricemia?

Some patients with hyperuricemia are asymptomatic, while others may suffer from complications such as gouty arthritis, gouty nephropathy, and tophi. Gouty arthritis is very common clinically and is primarily characterized by localized joint redness, swelling, heat, and pain. The commonly affected joints include the first metatarsophalangeal joint, ankle joint, and wrist joint. In cases of gouty nephropathy, patients may exhibit high levels of uric acid and increased creatinine levels, which may manifest as frequent urination, nocturia, and swelling of the lower limbs. If gout crystals deposit in the joints, they can form tophi, leading to joint deformities and restricted movement.