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    Home > Active Ingredient News > Endocrine System > The 5 most important problems of hyperuricemia are explained in one article!

    The 5 most important problems of hyperuricemia are explained in one article!

    • Last Update: 2021-06-04
    • Source: Internet
    • Author: User
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    *For medical professionals to read and refer to the 5 questions you are most concerned about about hyperuricemia, the answers are here~ 1 What is hyperuricemia: Under normal diet, check the blood uric acid level twice on an empty stomach, female> 360μmol/L (6mg/dL) and males >420μmol/L (7mg/dL) are diagnosed as hyperuricemia.

    2 Does hyperuricemia have to be treated? I often encounter such patients in the clinic.
    Physical examination found high blood uric acid.
    The doctor advised him to use uric acid-lowering drugs for treatment.
    However, he said that he had no gout or kidney stones.
    He felt nothing at all.
    Why should he be treated?
    Is this the fact? It is basically known that hyperuricemia causes gouty arthritis, tophi, gouty kidney stones, etc.

    But what many people don't know is that long-term high uric acid can also cause acute or chronic renal failure, metabolic syndrome, insulin resistance, coronary heart disease and other important organ damage.

    Hyperuricemia has many harms.
    It is definitely not just the problem of gout.
    It is not an exaggeration to say that it is the "fourth highest" after hypertension, diabetes, and hyperlipidemia.

    Hyperuricemia should be treated like hypertension, diabetes, and hyperlipidemia.
    Once it occurs, it must be treated actively.

    3 How much blood uric acid can be used to start medication? What is the goal of treatment? Once hyperuricemia is diagnosed, you should control your diet, change your life>
    However, studies have found that even after strict diet control, uric acid can only be reduced by less than 100μmol/L.

    Therefore, drug therapy is still the main treatment for lowering uric acid.

    Under what circumstances do you start medication? What is the goal of treatment? 1.
    Blood uric acid> 9 mg/dL (540 μmol/L): start unconditionally drug lowering uric acid treatment, the treatment goal is uric acid <7 mg/dL; 2.
    Blood uric acid> 8 mg/dL (480 μmol/L): if it occurs Uric acid-lowering therapy should also be started for any of the following conditions: (1) once gouty arthritis; (2) uric acid kidney stones; (3) renal dysfunction, glomerular filtration <90ml/min; ( 4) Hypertension; (5) Impaired glucose tolerance or diabetes; (6) Dyslipidemia (hyperlipidemia); (7) Coronary heart disease; (8) Obesity; (9) Stroke; (10) Heart insufficiency.

    Treatment goal: blood uric acid <6 mg/dL; if tophi occurs, or chronic gouty arthritis, or frequent attacks of gouty arthritis, the treatment goal is blood uric acid <5 mg/dL.

    3.
    As long as uric acid is high, start uric acid-lowering treatment: if gouty arthritis attacks ≥2 times, or gouty arthritis attacks once, and any of the following are combined at the same time: (1) age <40 years; (2) There is evidence of tophi or urate deposition in the joint cavity; (3) uric acid kidney stones; (4) renal dysfunction, glomerular filtration <90ml/min; (5) hypertension; (6) impaired glucose tolerance or Diabetes; (7) dyslipidemia (hyperlipidemia); (8) coronary heart disease; (9) obesity; (10) stroke; (11) cardiac insufficiency.

    The treatment goal is blood uric acid> 8 mg/dL (480μmol/L):.

    In any case, uric acid should not drop below 3 mg/dL (180μmol/L).

    Special note: my country uses μmol/L as the measurement unit of uric acid, while abroad generally use mg/dL as the measurement unit of uric acid, uric acid 1mg/dL=60μmol/L.

    4 What are the non-drug treatment measures for hyperuricemia? 1.
    Diet control: Promote a balanced diet, limit the total daily calorie intake, and focus on a low-purine diet.
    See the table for details.

     Special note: ①Some vegetables (lettuce, spinach, mushrooms, cauliflower, etc.
    ), beans and soy products, and HUA, etc.
    , although rich in purines, are rarely absorbed after ingestion, and are not significantly related to hyperuricemia and gout attacks Sex, encourage patients to eat more fresh vegetables, moderate consumption of beans and soy products.

    ② Fruits are rich in potassium and vitamin C, which can reduce the risk of gout attacks.

    Encourage to eat more fruits with less fructose, such as cherries, strawberries, pineapples, watermelons, peaches, etc.

    ③Alcohol can increase the production of uric acid, reduce the excretion of uric acid, and has obvious effect of producing uric acid.
    Alcohol intake should be restricted, and rice wine, beer and white wine should not be consumed.
    Red wine is better.

    2.
    Drinking plenty of water: Drinking more water can dilute uric acid.
    It is recommended to maintain a daily urine output of 2000-3000 ml.

    Drink milk and dairy products.
    Avoid fructose drinks or sugary soft drinks such as cola, orange juice, and apple juice.

    You can drink tea and coffee.

    3.
    Weight loss: Obesity increases the risk of gout, and weight loss can effectively reduce blood uric acid levels.

    It is recommended to control the weight within the normal range (BMI 18.
    5~23.
    9 kg/m2).

    4.
    Regular exercise: Encourage moderate exercise.
    It is recommended to do at least 150 min (30 min/d×5 d/week) of moderate intensity every week [heart rate during exercise is within the range of (220-age)×(50%~70%) ] Of aerobic exercise.

    5.
    Quit smoking and avoid passive smoking.

    5 What are the commonly used drugs for lowering uric acid? At present, the commonly used uric acid-lowering drugs in clinical practice include allopurinol and febuxostat, which reduce the production of uric acid, and benzbromarone, which promotes the excretion of uric acid.

    1.
    Allopurinol: One tablet of 100 mg per day, reduce the amount when the glomerular filtration rate is less than 30 mi/min, and it is forbidden when the glomerular filtration rate is less than 15 ml/min.

    The biggest problem of allopurinol is skin allergies.
    In severe cases, lethal exfoliative dermatitis can occur, and it is more likely to occur in Chinese (Han nationality), South Korea, and Thai people.

    It is recommended to screen for HLA-B*5801 gene before taking allopurinol.
    Those who are positive should not be allowed.

    2.
    Febuxostat: the initial dose is 20-40 mg/day, and the maximum dose is 80 mg/day.

    Febuxostat is mainly metabolized by the liver, so it is safer to use in patients with renal insufficiency and kidney transplantation.
    It is used with caution when liver function is impaired or severe renal insufficiency (glomerular filtration rate <30mi/min).

    3.
    Benzbromarone: starting dose 25-50 mg/day, maximum dose 100 mg/day, taken after breakfast.

    It is safe to use in patients with mild to moderate renal insufficiency or kidney transplantation.

    However, it is forbidden when the glomerular filtration rate is less than 20ml/min; therefore, the excretion of uric acid is promoted, and the content of uric acid in the urine is significantly increased, which is prone to urinary stones.
    Therefore, patients with uric acid nephrolithiasis are forbidden.

    Generally, a single drug is sufficient.
    If the effect of a single drug is not satisfactory for severe hyperuricemia, a combination of drugs can be used.
    The combination of febuxostat + benzbromarone is recommended.

    The combination of febuxostat and allopurinol is not recommended.

    Source of this articleResponsible editor of the Department of NephrologyBoom bang copyright statement This article is reproduced, welcome to forward it to the circle of friends -END-submission/reprint/business cooperation, please contact: pengsanmei@yxj.
    org.
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