Symptoms of hyperuricemia

Written by Li Hui Zhi
Endocrinology
Updated on September 21, 2024
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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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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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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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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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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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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.