Hyperuricemia can result from both congenital and acquired causes - genetic disorders and an inadequate diet can lead to it. Excessive uric acid levels in the body can be asymptomatic, but it can also lead to diseases associated with significant pain, such as kidney stones or gout.
Hyperuricemia( hyperuricemia ) is the increased level of uric acid in the blood. Uric acid is a substance formed during the metabolism of compounds such as purine bases or nucleic acids. Its excretion from the body occurs mainly through the removal of uric acid along with urine, while a small part (about 25%) goes to the digestive tract and is removed from it along with the faeces.
Physiologically produced uric acid in the body is removed from it and then its concentration in the blood serum does not exceed the normal limit, which is 7 milligrams of uric acid in a deciliter of blood. In a situation where the content of this substance in the blood exceeds the above-mentioned value, it becomes possible to diagnose hyperuricemia. It occurs in both men and women of all ages, because hyperuricemia can occur in many different ways.
Hyperuricemia: causes
Hyperuricemia usually occurs in one of three ways. The first is the increased production of uric acid, the second is its reduced excretion and the associated increase in its concentration in the blood, and the third mechanism is a combination of the two previously mentioned.
Hyperuricemia can appear both as a result of diseases existing in the patient from his birth, and develop in connection with burdens acquired during the individual's life. Primary hyperuricemia is said to result from genetically determined enzymatic disorders related to the metabolism of purine compounds. An example of this type of problem is Lesch-Nyhan syndrome. Hyperuricemia can also be acquired - the causes of elevated uric acid levels in the blood in this case may be:
- hypertension,
- use of certain medications (e.g. loop and thiazide diuretics, cyclosporine, acetylsalicylic acid or ethambutol),
- eating foods rich in purines (e.g.red meat),
- hypothyroidism,
- kidney failure,
- excessive alcohol consumption,
- obesity
Quite unusual conditions can also lead to hyperuricemia. The first is the so-called tumor lysis syndrome which can occur after the use of anti-cancer medicines. This condition is due to increased cell breakdown and hyperuricemia is one of its symptoms. Another possible cause of the increased level of uric acid in the blood is also the exceptionally high … physical exertion.
Hyperuricemia: symptoms
The hyperuricemia itself does not have to lead to the occurrence of any ailments in patients, what is more - even 2/3 of people with elevated uric acid do not develop any symptoms of hyperuricemia. Patients do not experience any he alth problems until they develop complications of hyperuricemia - the most common of which are gout and nephrolithiasis. During gout, sodium urate crystals accumulate in the joints, eventually leading to the development of inflammation of these joints. structures. Patients with gout may suffer from:
- severe pain and stiffness in the joints,
- impaired mobility in affected joints,
- redness and swelling of the articular structures.
Another condition that hyperuricemia can cause is nephrolithiasis. Forming gout deposits may be small and be excreted from the body along with urine, while larger formations may be located in the structures of the urinary system and lead to such ailments as:
- severe pain (localized in various places, e.g. in the loin, abdomen or groin),
- nausea,
- soreness when urinating,
- blood in urine,
- difficulty urinating.
Hyperuricemia: diagnostics
Hyperuricemia itself is diagnosed by measuring the concentration of uric acid in the blood. Sometimes, in patients suspected of having hyperuricemia, urine measurement of the compound is also ordered. Other tests performed in patients who may have elevated uric acid levels depend on their symptoms. For example, in people with gout, it is possible to collect fluid from the affected joints for analysis, in which it is possible to detect the presence of sodium urate crystals. On the other hand, in the diagnosis of patients with suspected renal urolithiasis, imaging tests, such as ultrasonography, can be used, which allow to visualize the localizedurinary deposits.
Hyperuricemia: treatment
Treatment of hyperuricemia is not always necessary. For people in whom this condition does not lead to any symptoms, treatment is usually only initiated when the uric acid level in their blood exceeds 12 mg / dL.
The situation is different for patients who developed gout due to hyperuricemia. In this case, the treatment is twofold: patients are given drugs to stop the attack of gout (such as colchicine or non-steroidal anti-inflammatory drugs), as well as preparations to prevent subsequent episodes of the disease. In the treatment of preventing gout attacks, drugs that reduce the concentration of uric acid in the plasma are used. Allopurinol, febuxostat, benzbromarone and probenecid can be given as representatives of this group. However, the treatment of hyperuricemia involves more than just pharmacotherapy. Patients should also beware of consuming substances that can lead to an increase in uric acid levels in the blood - such as certain foods (such as offal, red meat or sweet products with a high fructose content) and alcohol. In order to reduce the risk of hyperuricemia, it is also necessary to properly treat the patient's other conditions (e.g. high blood pressure or diabetes), and in obese people there is a need to lose weight.