Hyperuricemia is a chronic disorder that is accompanied by an increase in the concentration of uric acid in the bloodstream. Normally, the values are in negligibly small ranges: approximately 360 µmol per liter of blood. With a disorder of this type, a jump of several times is not the limit.
An increase in the concentration of uric acid is extremely dangerous for the body. If there are no symptoms at the first stages of the disease, then a clinical picture and disturbances in the body’s functioning appear. Kidney, liver.
Joints and other body structures are affected. Therefore, treatment must be started immediately. As soon as such an unpleasant find appeared in a biochemical study.
Development mechanisms
Hyperuricemia (also known as uricemia or hyperuricosuria) has its own ICD-10 code. E79. Strictly speaking, this is a somewhat generalized disorder. But an increase in the amount of uric acid fits into it.
The disease develops against the background of one or more factors. The question is quite complicated. Especially from a diagnostic point of view.
First
The first possible option is a metabolic disorder. In particular, purine metabolism. These compounds are natural building materials for the body. Moreover, for its foundation. Since normal purine metabolism ensures the reconstruction of DNA and RNA molecules. This is a kind of basis for all other processes in the body.
Purines are found in all foods. Huge amounts can be found in meat, fish, sausages, tea, coffee, vegetables, and cereals.
This doesn't mean you need to go on a strict diet. But when consuming such foods, the risk of increased uric acid also increases.
Why a metabolic disorder occurs is another question. Pathologies of the liver, kidneys, and endocrine system are possible.
Second
This mechanism concerns fructose consumption. Saccharides are metabolized in the liver. There they are processed. In this case, uric acid is a byproduct of complex biochemical reactions.
When fructose breaks down, the substance is released into the bloodstream. The more, the more intense the pathological process will be. The risks increase tenfold if the patient has diabetes.
Third
Impaired excretion of metabolic products. Basically, waste compounds are eliminated naturally. Particularly active in urine. However, if the filtering function of the kidneys is impaired, normal metabolism cannot be expected.
The problem arises with dysfunctional deviations, failure of a paired organ. The more intense the violation, the worse the situation is.
With renal disorders, oliguria occurs. Urine becomes small, no more than 50 ml per day. Waste metabolic products enter the bloodstream and poison the body.
Often all three mechanisms are found in the same patient. This worsens the overall prognosis and complicates treatment. Although the chances of recovery are high. It just takes more work and self-discipline.
How to treat?
To reduce the symptoms of the disease, medications are prescribed that accelerate the excretion of uric acid and ease the load on the kidneys:
- Probenecid. Previously, the drug was used to facilitate the action of penicillin on the renal tubules, and recently it has been actively used against gout;
- Orotic acid is a vitamin-like substance that speeds up metabolism;
- Allopurinol, regulates the synthesis of uric acid;
- Urodane facilitates the functioning of the gastrointestinal tract.
Classification
Several criteria for typing a disorder can be identified. The first concerns precisely the mechanism of disease development.
Accordingly they are called:
- Renal hyperuricosuria. It accompanies any kidney disorder. Including failure, nephropathy or inflammatory processes. Like pyelonephritis or autoimmune glomerulonephritis.
- Metabolic form. Caused by disruption of normal metabolism in the body. Such disorders are almost always secondary. That is, they are caused by other diseases. For example, diabetes mellitus, damage to the thyroid gland, pituitary gland. Congenital variants are extremely rare.
- Liver form. As the name suggests, it occurs in pathologies of the largest gland. The reason is the low activity of the organ.
- The nutritional variety is caused by the incorrect actions of the patient himself. Irresponsible attitude towards nutrition. With high consumption of glucose and alcohol, hyperuricemia is likely.
- Mixed type. It has the characteristics of the above varieties in any combination.
The pathological process is also classified according to its more general origin:
- Congenital disorders. Seen infrequently. As already said.
- Acquired form. It is observed in almost 99% of cases, if not more.
Sometimes the classification refers to the severity of the disorder. But this typification is not universally accepted. There are differences by country.
Divisions into types are used to better understand the process, describe it and quickly select a set of diagnostics and treatment. This is an indispensable tool in the arsenal of specialists in endocrinology and related specialties (for example, hematology).
Prevention
As many doctors say, it is better to prevent a disease than to treat it. Therefore, regular visits to the doctor, getting tested and following the basic rules of a healthy diet will help avoid the negative consequences of hyperuricemia.
There is no need to provoke the body by loading it with excess alcohol or fatty foods. An unhealthy lifestyle can be a factor that triggers the development of hyperuricemia.
Symptoms
Interestingly, the clinical picture mainly occurs in children. Adult patients experience the pathological process with virtually no symptoms. Although there are exceptions.
Signs of the disorder can be described in a small list:
- Arthralgia. Simply put, joint pain. A special case of hyperuricemia is gout. When uric acid crystallizes and deposits in cavities and other joint structures.
As a rule, small peripheral tissues are the first to be affected. For example, big toes.
As the disease progresses, large joints, such as knees, hips, and elbows, are also involved. The violation can last for years, then recurring, then dying down again.
- Muscle pain. Discomfort occurs spontaneously. The nature of the sensations resembles those during inflammatory processes. Myositis (the well-known expression “inflated” the neck or lower back well explains the essence of the phenomenon and the “unforgettable” sensations).
- Increased sensitivity to all irritants. Light, noise. Patients literally cannot withstand even the average volume of sound; this sign of hyperuricemia is especially common in children. Adults endure it even harder, since they are forced to spend most of their time in a noisy society.
- Cramps. As a rule, they are represented by the simplest hyperkinesis. For example, tics. Voluntary wave-like muscle contractions without pain are typical symptoms of hyperuricemia.
Other types of seizures are possible, but not common. Usually in 2-5% of cases of the total. And then, they occur in children. In adults, only tics are present. Why such symptoms occur is not yet known for certain.
- Liver disorders. Also the gallbladder. Deviations relate to the outflow of bile. Critical disorders are possible, including obstructive jaundice and cholecystitis. There are many options.
Interestingly, secondary liver damage is accompanied by impairment of its functions. Consequently, purines and uric acid will accumulate even more actively. Is it worth saying how this will end?
It is worth repeating that asymptomatic hyperuricemia is typical in adult patients. They don't experience any discomfort.
Symptoms appear only when the kidneys are involved in the pathological process. Possible pyelonephritis. Inflammation of the tissues of a paired organ of infectious origin.
Accordingly, specific signs:
- Pain in the lumbar region. Intense. Worse before urination. They calm down after. They do not respond to the physical activity of patients.
- False urges to visit the toilet are frequent. The so-called pollakiuria.
- Then much more menacing symptoms arise. For example, polyuria. When an unnatural amount of urine is produced. Over 2 liters. Up to 5-6. The patient experiences dehydration, hypovolemia (when the volume of circulating blood decreases).
- At advanced stages of the disorder, the opposite phenomenon occurs - oliguria. That is, insufficient amount of fluid released.
The clinical picture is complex. It is extremely difficult to say that something is wrong. Only diagnostics puts an end to the question.
Causes and treatment
The factors are varied. Not all are pathological. You can name dozens of culprits for the disorder.
Poor diet high in purines
They are found in all products. There are especially many of these substances in red meat and alcohol. Therefore, food lovers are in a high-risk area. Purines come naturally. Which is what causes the violation.
Treatment. It is enough to adjust your diet. There is no need to go on a starvation diet. Moreover, this will not help. It is important to include more white dietary meat in your menu. Fruits, fresh vegetables. Completely eliminate alcohol from your life.
The same goes for insatiable consumption of sweets. Sakharov. You need to limit yourself a little. Then the concentration of uric acid will drop by itself, and everything will return to normal.
Hypertension
Associated with increased blood pressure. The problem is that with this disease, blood moves through the vessels slowly. Consequently, normal renal filtration becomes problematic and hyperuricemia develops. Including due to damage to the paired organ. It makes sense to undergo diagnostics and a course of therapy.
Treatment. Correction of high blood pressure. Specialized drugs are used. For example, ACE inhibitors, sartans, beta blockers, calcium antagonists and centrally acting agents.
Diuretics and statins (fight lipids and fats) are prescribed as needed.
There are plenty of options. Treatment issues are best left to cardiologists.
Inflammatory kidney diseases
Pyelonephritis and glomerulonephritis as the main causes of hyperuricemia. Lesions of the excretory system negatively affect metabolism. Since purines, their products and derivatives, uric acid are not eliminated quickly and efficiently enough.
Treatment. Pyelonephritis is treated with anti-inflammatory drugs and antiseptics. Diuretics are also prescribed. Not necessarily in the form of tablets or classical drugs. They resort to the help of herbal remedies. If the patient does not have allergies.
Tumor processes
Oncology itself is extremely dangerous. Violations of purine metabolism are due to the essence of neoplasia. When cells break down, destruction products are released into the bloodstream. Including purines, uric acid itself. This is a complex biochemical process.
Treatment. Always required and as quickly as possible. An operation is scheduled. The surgeon’s task is to excise the malignant tumor as much as possible. Only in this case there is a chance of recovery.
Chemotherapy and radiation therapy are prescribed as needed. To get rid of the remnants of the tumor, eliminate those parts that could not be removed surgically.
Diabetes
Classic endocrine pathology. Accompanied by metabolic disorders. And all at once. Purine, lipid, etc.
The patient is faced with a lot of problems. An increase in uric acid concentration is the lesser of the evils.
Treatment. Strict low sugar diet. If necessary, administer insulin. To artificially reduce the amount of glucose in the blood.
Iron-deficiency anemia
It is also accompanied by metabolic disorders. Read more about the mechanisms of development of iron deficiency anemia and treatment methods in this article.
The therapy is quite simple. It is necessary to systematically administer iron supplements in high concentrations over a week or more. This way you can adjust the amount of the substance.
However, another problem is possible. Sometimes iron is not absorbed due to disruption of the internal organs. Small intestine, as an option.
Then you also need to treat the root cause. Otherwise, the compound will not be absorbed on its own.
Pregnancy
Gestation itself is a great stress for the body. The body rearranges biochemical processes in a different way. Purine metabolism is also transformed.
If the mother has problems with the kidneys, liver, internal organs, or hormonal levels, problems cannot be avoided. At a minimum - more intense toxicosis. Often there are also disorders of uric acid excretion.
Treatment. No special therapy is required. At least if the mother is completely healthy. Otherwise, the issue should be discussed with a gynecologist and an endocrinology specialist.
Infectious diseases
Violations like the ones described are quite rare, but it is possible. It makes sense to correct the condition. Then everything will return to normal.
Treatment:
- Antibiotics against the background of bacterial infection.
- Antiviral drugs to enhance the production of interferon or provide it in finished form.
- Fungicides if the disease is caused by fungi.
Hereditary abnormalities
Lack of certain enzymes, etc. All of them are genetically encoded, therefore there is no treatment as such. Only struggle with symptoms throughout life. Fortunately, such forms of disorder occur in less than 1% of cases.
As soon as the cause of hyperuricemia becomes clear, therapy can begin. In addition to the actual fight against the root cause, it is necessary to correct the uric acid levels themselves.
Drug treatment of hyperuricemia includes taking special medications: for example, Allopurinol in a adjusted dosage. There are similar means. The doctor decides what to prescribe.
A huge role is given to proper nutrition. This is not just a diet, but a revision of the principles of diet. Less fatty meat, alcohol. More fresh plant foods. Refusal of canned food, sausages, chocolate, coffee.
Recommended diet for hyperuricemia
The fight against this disease begins with diet and nutrition. Purine-containing foods are completely excluded from the daily diet. Let us consider in more detail what rules should be followed by patients with hyperuricemia during a diet.
Protein food restrictions
It is not recommended to eat turkey, chicken, rabbit, or lactic acid products. Even dishes made with fish broths are not very healthy.
It is optimal to adhere to a vegetarian diet, giving preference to fresh vegetables, fruits, cereals and herbs. Eating lean, dietary varieties of meat and fish is considered acceptable (no more than three times a week).
For therapeutic therapy, it is important to have foods containing potassium:
- eggplant;
- pumpkins;
- white cabbage;
- cucumbers;
- bell peppers
Eat fresh or prepare dishes from fruits:
Drinking diet
For hyperuricemia, drink a lot of water (2 liters or more per day). Eating artichoke soups, broths and porridges also helps remove harmful urates from the body.
It is useful to carry out fasting days once a week:
- In the morning on an empty stomach, do an enema with the addition of a decoction of chamomile or calendula;
- throughout the day they drink water, green or herbal teas, always without sugar and honey;
- in the evening they do the enema again;
- For the next two days, eat steamed vegetables or cereals without milk and avoid “heavy” foods.
Minimum animal fats
Animal fats: lard, sausages, butter and other products have a negative effect on the liver, so they should be excluded from the diet.
Alcohol ban
As you know, alcohol is one of the most destructive substances that destroys the structure of the liver and impairs the functioning of this organ. For this reason, all drinks containing alcohol are strictly prohibited.
Cooking Features
All dishes must be boiled or stewed. It is better to eat fresh vegetables, fruits, and herbs. Fried and even baked foods are contraindicated.
Food is a source of energy and important microelements; to be healthy, it is important to monitor what constitutes your daily diet and adjust your diet according to the recommended diet.
Diagnostics
The examination is carried out by endocrinologists. Less often specialists of other profiles.
A sample list of events would be:
- Oral interview and collection of anamnestic data. Doctors are also interested in lifestyle, nutrition, past and current diseases. Anything that may be useful for describing the pathology.
- General blood test.
- Biochemical research. Used to study the amount of iron.
- Doctors are also interested in liver tests (ALT, AST). This is an informative technique.
- Ultrasound of the liver and internal organs. To exclude possible deviations from the largest gland. If necessary, MRI is prescribed to better visualize the tissue.
- Liver scintigraphy. Functional study. It is based on the effect of a radioactive isotope on the body.
- Ultrasound of the kidneys.
- General urine examination.
If the suspected etiology concerns hereditary anomalies, a consultation with a geneticist is prescribed. If necessary, a bone marrow puncture is performed.
Sometimes an increase in acid concentration is due to damage to the hematopoietic system. The question is complex. Even doctors need more than one week to make a correct diagnosis.
Possible consequences
There are quite a lot of complications. This:
- Gout. Inflammation of peripheral joints. Hence cartilage deformations and disability. Without quality treatment.
- Pyelonephritis.
- Kidney failure.
- Nephrolithiasis. Simply put, it is the formation of stones in a paired organ of the excretory system.
Lethal complications also occur. But extremely rarely. Treatment usually arrives faster.
Hyperuricemia is a complex condition. Correction is needed as soon as possible. To avoid dangerous consequences.
