HYPERURICEMIA AND GOUT

Excess of uric acid in the blood is called hyperuricemia. Uric acid is a nitrogenous waste, excrete through urine mainly in lower vertebrates i.e birds. As uric acid is present in small quantity in human urine, its increased amount in urine indicates some pathological conditions like renal calculi, gout etc in the body.

While gout is a complication of hyperuricemia and a metabolic disease characterized by painful inflammation of the joints, mainly caused by deposition of urates in the joints. It causes swollen and stiffed joints. Gout can occur at any joint usually large joint of big toe. Other joints may affected are knees, ankles, heels, elbows, wrists and fingers.

Gout ensues as a result of elevated uric acid in the blood. Uric acid comes from break down of purines. Normally uric acid in the blood passes to kidneys and excrete through urine, sometimes it build up and forms crystals. These crystals assembles into joints results in a very painful condition.

When the concentration of uric acid in urine exceeds its solubility, uric acid changes into insoluble precipitates, results in uric acid stones. But it is very rare condition i.e 20% of total cases of renal stones.

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NORMAL VALUE OF URIC ACID:

Normal level in males:  3.4-7.0 mg/dL

Normal level in females;  2.4-6.0 mg/dL

COMPLICATIONS OF HYPERURICEMIA:

Following are some possible complications of hyperuricemia;

  1. Gout
  2. Uric acid stones
  3. Acute uric acid nephropathy
  4. Chronic renal disease

COMMON SYMPTOMS OF GOUT:

  1. Severe joint pain, most severe in the first 12-24 hours.
  2. Tenderness and swelling of the joints.
  3. Joint pain spreads to more joints over time.

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CAUSES OF ELEVATED URIC ACID:

Hyperuricemia can be primary (increased uric acid level due to purine) or it may be secondary (increased uric acid level due to other diseases).

Some causes are;

  1. Increased production of uric acid from purine.
  2. Certain cancers and after chemotheraphy, as there is rapid amount of cellular destruction.
  3. Kidney diseases, means kidney becomes unable to clear the uric acid out of the system.
  4. Endocrine conditions i.e diabetes and acidosis.

HOW TO REDUCE URIC ACID LEVEL:

  1. Limit usage of purine-rich foods. These food includes alcoholic beverages, seafoods, some meats i.e bacon and veal, and organ meat like liver, beans, spinach, mushrooms, cauliflower etc.
  2. Avoid sugary foods.
  3. Avoid alcohol, as drinking alcohol can decrease the kidney’s ability to filter uric acid.
  4. Loss of weight, being overweight increases the chances of gout attack.
  5. Diabetic people are also at risk to gout, so keep a balance insulin level.
  6. Add more fibers to routine diet.

TREATMENT OF GOUT:

  1. NSAIDs like ibuprofen and naproxen are suggested by physicians for relief of pain caused by gout.
  2. Xanthine oxidase inhibitors, these drugs reduce synthesis of uric acid by inhibiting xanthine oxidase. i.e Allopurinol
  3. Uricosuric drugs, these drugs prevent uric acid deposition in tissues and increase urination i.e Probenecid
  4. Drinking plenty of water, regular exercise, maintaining a healthy weight and avoiding purine rich foods and beverages are also advised by physicians.

 

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He is owner of this website. He is MBBS student in Bannu Medical College, Khyber Medical University Pakistan.

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