Definition

Uric acid is one of the final substances found in the blood. It is formed when the body breaks down the purine molecules. A large amount of uric acid dissolves in the blood, circulates through the kidneys, and exits the body by urination.

Hyperuricemia develops when there is an excess of uric acid in the blood. Hyperuricemia is defined as high levels of uric acid in the bloodstream that are beyond normal ranges.

Uric acid crystals may develop as a result of hyperuricemia. These crystals may become stuck in the joints and create arthritis or gout, leading to joint inflammation that causes severe pain. Kidney stones will develop if these crystals form or settle in the kidneys.

Causes

Hyperuricemia is a condition characterized by elevated levels of uric acid in the blood. Uric acid is produced during the bodily breakdown of purines. The following purine-rich foods and beverages can elevate uric acid levels:

• Sardines, salmon, prawns, and lobsters
• Beef
• Offal, including tripe, liver, and intestines
• Alcohol

The typical mechanism for the elimination of excess uric acid from the body is the production of urine. However, hyperuricemia occurs when uric acid production is excessive or the excretion process is inadequate. The inability of the kidneys to eliminate uric acid at an appropriate rate or at all might be the underlying cause of this condition.

Risk Factor

Although all individuals are equally susceptible to hyperuricemia, this risk is generally higher among men and becomes more prevalent with age.

Several factors can increase an individual's susceptibility to hyperuricemia, including:

• Alcohol consumption
• Certain medications (particularly cardiovascular diseases)
• Exposure to lead or pesticides
• Renal abnormalities
• Hypertension
• Elevated glucose levels
• Hypothyroidism
• Excessive weight gain
• Extreme exercise

Read more: Hypothyroidism: Definition, Cause, Symptom, And Laksana AI Care (ai-care.id)

Symptoms

Most individuals with hyperuricemia are asymptomatic and do not necessitate prolonged treatment. Approximately only one-third of individuals with hyperuricemia exhibit symptoms, while the remaining two-thirds experience no symptoms, a condition referred to as asymptomatic hyperuricemia.

While hyperuricemia may initially be asymptomatic, persistent elevation of uric acid levels can eventually lead to several disorders and associated symptoms.

Gout

Gout is a prevalent type of arthritis characterized by joint inflammation. Gout results from the accumulation of uric acid crystals in the joints and surrounding tissues, leading to inflammation. 

The symptoms consist of:

• Severe joint pain
• Stiff joints
• Limited mobility
• Joint swelling and redness

Kidney Stones

Kidney stones, also known as nephrolithiasis or renal calculi, result from solid deposits composed of minerals, salts, and other substances within the kidneys. Kidney stones are initially microscopic, but they may gradually enlarge over time.

These are some of the symptoms of kidney stones:

• Groyne and lower abdominal pain
• Colic or severe back pain
• Nausea
• Polyuria (increased urination frequency)
• Dysuria (urinary pain)
• Difficulty urinating
• Hematuria (blood present in urine)

Diagnosis

Uric acid level monitoring is not performed regularly. If you experience signs and symptoms of gout or kidney stones, your doctor may check your uric acid levels. The doctor may also perform a physical, a laboratory, and other necessary examinations.

Physical examinations

The doctor will observe inflammation, elevated temperatures, and a reddish appearance in the affected joints. The thumb joint is the most commonly affected. If you experience kidney stone symptoms, the doctor will conduct a physical examination by assessing the waist, groin, and lower abdomen for signs of discomfort.

Laboratory examinations

The doctor will advise you to take a blood test to assess the concentration of uric acid in your blood. The doctor may also suggest conducting a comprehensive blood examination, including a complete blood count, blood lipid analysis, a comprehensive metabolic panel, and a calcium and phosphate level. These tests may help determine the underlying reason for the elevated uric acid levels.

Additional examinations

When kidney stones are suspected, the doctor may perform additional diagnostic procedures, such as an ultrasound.

Management

The management of hyperuricemia differs depending on its underlying causes. If hyperuricemia has no symptoms (asymptomatic), then treatment is not recommended. There is no evidence that uric acid-lowering medication administration for asymptomatic hyperuricemia is beneficial. However, if hyperuricemia leads to several diseases, treatment is necessary.

To help relieve the pain and inflammation caused by gout attacks, the doctor might prescribe pain relievers and anti-inflammatory medications. To prevent the accumulation of uric acid deposits and their severe effects, the doctor may also recommend treatments to reduce uric acid levels.

Treatment for kidney stones is determined based on the size of the stone. In the case of a small stone, the doctor will prescribe analgesics and recommend adequate hydration and fluid intake to enhance the urinary excretion of the stone. The doctor may also recommend specific medical treatments to break down the kidney stones if they are enormous. In some instances, surgical intervention may be necessary if the oral medications cannot eliminate all the kidney stones.

Read more: Kidney Stone Disease (Nefrolithiasis): Definition, Cause, Symptom, and Laksana AI Care (ai-care.id)

Complications

Elevated and unregulated levels of uric acid may lead to several health complications, including:

• Gout
• Kidney stones
• Hypertension
• Diabetes
• Metabolic syndrome

Prevention

Healthy dietary choices can help control uric acid levels in the blood. Dietary modifications may lower the risk of gout attacks and delay the progression of joint damage. 

Although the body can produce purines, they can be found in particular foods. Purine-rich foods that you should avoid include the following:

• Beef
• Sweet foods and beverages, particularly those that include high-fructose corn syrup
• Offal, such as liver and intestines
• Seafood, including anchovies, sardines, and shellfish
• Tuna and cod
• Spinach, peas, and mushrooms
• Nuts
• Alcohol

It is also recommended to exercise regularly, stay hydrated, and maintain an average body weight.

When to see a doctor?

Schedule routine examinations to assess your health. Hyperuricemia frequently has no symptoms; therefore, early detection of hyperuricemia may be helpful in the prevention of further complications. See your doctor right away if your hyperuricemia symptoms indicate gout or kidney stones.

You can also use our consultation services with doctors on the Ai Care application, which is available on the Play Store and App Store.

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