Can hyperuricemia be cured?

Written by Chen Xie
Endocrinology
Updated on September 02, 2024
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Hyperuricemia is a metabolic disease caused by disorders in purine metabolism and is clinically divided into primary and secondary categories. Primary hyperuricemia is caused by congenital abnormalities in purine metabolism and is often associated with obesity, dyslipidemia, hypertension, atherosclerosis, and coronary heart disease. Secondary hyperuricemia, on the other hand, is caused by certain systemic diseases or medications. Therefore, whether hyperuricemia can be cured depends on the underlying condition, and the efficacy of treatment cannot be generalized. For hyperuricemia caused by medications or systemic diseases, it can be cured by treating the disease or discontinuing the medication. However, for hyperuricemia caused by congenital abnormalities in purine metabolism, it can be clinically managed by controlling diet and medication, but it is not curable.

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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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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
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What are the harms of hyperuricemia?

The dangers of hyperuricemia: Firstly, some individuals might experience gouty arthritis, characterized by localized joint swelling, redness, heat, and pain, affecting mobility. Secondly, prolonged hyperuricemia can damage the kidneys, leading to chronic renal failure. Thirdly, if hyperuricemia persists long-term, it may result in the formation of tophi. Tophi deposited in joints can cause joint deformities and limited mobility. Additionally, hyperuricemia is an independent risk factor for cardiovascular and cerebrovascular diseases, and thus should be taken seriously.

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Written by Zhang Jun Jun
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Pre-symptomatic hyperuricemia

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 Li Hui Zhi
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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.