What are the symptoms of hyperuricemia?

Written by Li Hui Zhi
Endocrinology
Updated on April 02, 2025
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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.

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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 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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Written by Li Lang Bo
Endocrinology
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Can people with hyperuricemia eat eggs?

In the case of hyperuricemia, we primarily recommend a low-purine diet to prevent the onset of gouty arthritis. As for the nutritional content of eggs, they are considered a food with a moderate level of purines. Therefore, when uric acid levels are relatively high, it is still possible to consume them in moderation. Aside from diet, it is also necessary to drink plenty of water or to alkalize the urine using baking soda tablets even if there is a transient increase in blood uric acid levels. If sufficient water is consumed, it is less likely for deposits to form in the joints. If deposits do not easily form, it also relatively reduces the possibility of triggering inflammatory responses, thus preventing the occurrence of gouty arthritis. Therefore, it is possible to consume an appropriate amount of eggs, but it is also important to drink plenty of water and appropriately alkalize the urine.

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Written by Zhang Jun Jun
Endocrinology
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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 Lin Xiang Dong
Endocrinology
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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.