An increase in uric acid levels in human blood is classified as hyperuricemia. What it is? This is the result of a violation of purine metabolism, often due to environmental factors (nutrition and others) and a genetic factor. This pathology attracted attention after repeated screening studies that revealed its effect on the course of cardiovascular diseases. It is also considered the leading biochemical sign of gout. Hyperuricemia is often asymptomatic, as a result of which it is not always immediately detected.
When does hyperuricemia occur?
Uric acid is the final metabolic product of purine bases. Formed in the liver, it is excreted in the urine. An increase in its concentration in blood plasma indicates the development of some pathological conditions. This leads to hyperuricemia. If uric acid levels decrease, hypouricemia develops. Its normal level is with a maximum indicator in women of 360 ΞΌm / l, in men it is 400 ΞΌm / l. Exceeding these indicators requires clarification of the causative factors that result in hyperuricemia.
What it is? This is the result of excessive formation of uric acid and impaired renal function, the main symptom of gout. It may also be evidence of pathological conditions such as lymphoma, leukemia, anemia due to a deficiency of vitamin B12, diseases of the biliary tract, liver, kidneys, psoriasis, pneumonia, gestosis, tuberculosis, diabetes mellitus, and chronic eczema.
In the early stages of purine metabolism disorders, kidney damage develops, outstripping attacks of gouty arthritis and other symptoms. The fact is that the kidneys are the first to be included in the process of compensating for excess synthesis of uric acid, increasing the normal excretion of urates, which contributes to the risk of crystallization of these salts in the kidneys. Increased excretion (excretion) of uric acid has a damaging effect on the tubules, renal interstitium, contributing to the development of diseases such as hyperuricosuria and hyperuricemia. The first pathological condition is caused by an increased concentration of uric acid in the urine, which is caused by a violation of purine metabolism due to malnutrition, rich in purine bases, a high-protein diet, and alcohol abuse. The second is detected by a biochemical blood test.
Types of Hyperuricemia
Hyperuricemia is primary and secondary. The first is often due to primary gout, a family-genetic abnormality of purine metabolism (constitutional dyspurinism). According to causal factors, it is divided into three types:
- metabolic type, due to an increase in the synthesis of endogenous purines and characterized by high uricosuria and the rate of purification of biological tissues and body fluids (clearance) of uric acid;
- renal type caused by impaired urinary acid excretion by the kidneys and characterized by low clearance;
- mixed type, which is a combination of the first two conditions in which uraturia is reduced or does not exceed the norm, and the clearance is unchanged.
Symptoms of the disease
Recently, often during a medical examination during blood donation for biochemical analysis, hyperuricemia is diagnosed. "What it is?" - The first question that patients ask, because they did not notice any signs of the disease. The disease, in fact, often passes almost asymptomatically.
How harmless is such unexpressed hyperuricemia, the symptoms of which, when manifested, are mostly nonspecific? In childhood, this pathological condition can be expressed by constipation, abdominal pain, nocturnal enuresis, logoneurosis, tics, excessive sweating. In adolescents, symptoms of hyperuricemia are more often manifested, such as overweight, pain in the lumbar region, itching in the urethra, biliary dyskinesia. Intoxication and asthenization can join the clinical picture. In adults, at an early stage of the development of pathology, interstitial nephritis is formed. It is able to modify into pyelonephritis of the secondary type under the influence of a bacterial infection, creating favorable conditions for the formation of kidney stones. Urolithiasis, or nephrolithiasis, is not uncommon. The following metabolic disorders should be noted as the basis for the formation of urinary stones: changes in the acidity of urine, hypercalciuria, hyperoxaluria, hyperphosphaturia, hyperuricuria and hyperuricemia. Hyperuricemia is often combined with various pathologies of the digestive tract.
Risk factors
The disease, developing against the background of accelerated formation of uric acid, is more often caused by the influence of such factors:
- the participation of purine in metabolic processes;
- impaired renal function;
- high fructose in your daily diet.
Causes of Hyperuricemia
The main causes of this condition are the abuse of foods saturated with purines, fatty foods. No less dangerous is starvation, as well as tissue destruction, malignant neoplasms. May contribute to the development of hyperuricemia diseases of the lymphatic system, blood.
Treatment
Deterioration of the filtration properties and violations of the tubular renal function is the trigger mechanism that provokes such a pathology as hyperuricemia. What kind of condition is it, hereditary or acquired? The acquired condition often develops in the elderly as a result of sclerosis of the vessels of the kidneys. Hyperuricemia is also often a companion of such pathologies as anemia, chronic eczema, acidosis, psoriasis, toxicosis during pregnancy.
When a diagnosis of hyperuricemia is established, treatment is prescribed on the basis of laboratory data and other types of additional examinations. Its basis is diet therapy. Products containing a significant amount of purine derivatives are excluded from the patientβs diet, or their consumption is significantly reduced. The drug course includes uricose suppressor drugs, drugs with uricosuric action. An important aspect of treatment is the achievement of an alkaline urine reaction. Self-medication is unacceptable, even a diet is developed according to an individual plan in order to prevent one of the serious complications - gout.