Hyperuricemia and Its Complications

Written by Li Hui Zhi
Endocrinology
Updated on September 13, 2024
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Hyperuricemia mainly refers to the elevation of uric acid levels in the blood, with levels exceeding 420 umol/l in males and 360 umol/l in females being diagnostic criteria. Some patients with hyperuricemia may not show symptoms, but if not controlled, complications can arise such as gouty arthritis, which manifests as local joint redness, swelling, heat, and pain, and even limited mobility. If it affects the kidneys, it leads to gouty kidney, which is characterized by abnormal kidney function and elevated creatinine levels. Therefore, if diagnosed with hyperuricemia, it is advisable to control diet, drink plenty of water, and seek timely medical treatment.

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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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Can hyperuricemia be cured?

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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Symptoms of hyperuricemia

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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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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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.