Hyperuricemia treatment agent

Written by Luo Juan
Endocrinology
Updated on November 29, 2024
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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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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 Chen Xie
Endocrinology
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How is hyperuricemia treated?

The treatment of hyperuricemia mainly includes: First, improving lifestyle, including healthy eating with a low-purine diet, quitting smoking, drinking more water, exercising regularly, and controlling weight. Second, alkalinizing the urine using sodium bicarbonate to maintain urine pH between 6.2 and 6.9, which facilitates the excretion of uric acid. Third, avoiding medications that increase blood uric acid levels, such as diuretics, corticosteroids, and insulin, among others. Fourth, using medications that lower uric acid, including drugs that increase uric acid excretion, mainly benzbromarone and probenecid, and drugs that inhibit uric acid synthesis, such as allopurinol and febuxostat. The choice of medication has specific indications, contraindications, and side effects, and it is advised to use these medications under the guidance of a specialist and not to self-medicate.

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Written by Lin Xiang Dong
Endocrinology
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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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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 Luo Juan
Endocrinology
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What fruits to eat for hyperuricemia?

For patients with hyperuricemia, we generally need to limit the intake of high-purine foods, such as crab and animal offal. Moderate consumption of medium-purine foods, such as meats and fish, is acceptable. Low-purine foods like vegetables, fruits, milk, and eggs can be safely consumed. For example, fruits like grapes, pears, grapefruits, kiwis, and dragon fruits are all acceptable to eat. However, many patients with hyperuricemia also have other metabolic abnormalities, such as high blood sugar. In such cases, it is important to monitor the quantity of fruit intake because excessive consumption can lead to fluctuations in blood sugar levels. Therefore, fruits can be safely consumed by those with hyperuricemia, but attention must be paid to any additional metabolic abnormalities that may be present.