Hyperuricemia: Causes, Symptoms, Treatment and Cost

A medical disease known as hyperuricemia occurs when there is an excessively high quantity of uric acid in the blood of the patient. When purines are broken down in the body, uric acid is generated as a waste product.

This process results in the formation of uric acid. Purines are found naturally in certain foods, such as anchovies, sardines, organ meats, and some types of seafood. High levels of uric acid can lead to a variety of health problems, including gout, kidney stones, and other forms of kidney disease.

Hyperuricemia is divided into two main types: primary and secondary.

• Primary hyperuricemia: It is caused by the body’s inability to process uric acid normally. This can be due to genetic factors or acquired conditions, such as being overweight or having high blood pressure.
• Secondary hyperuricemia: It is caused by other medical conditions, such as cancer, kidney disease, or certain medications.
• Uric acid crystals can also build up in the kidneys and urinary tract, leading to kidney stones and other symptoms.

Hyperuricemia is caused by a variety of factors, including:

• Uric acid production is excessive.
• A lack of uric acid excretion brought on by dysfunctional kidneys.
• Increase in purine intake through diet.
• Certain medications, such as diuretics and aspirin, can also contribute to hyperuricemia.
• Genetic factors may also play a role in some cases.

The most common symptom of hyperuricemia is gout, which is a form of arthritis that causes pain, swelling and redness in the joints.Another sign may be fatigue. renal issues, including kidney stones, weight loss, joint heaviness or sensitivity, and a reduced appetite.

To prevent hyperuricemia, you can take the following measures:

• Maintain healthy lifestyle habits.
• Exercise regularly.
• Maintain a healthy weight.
• Limit alcohol consumption.
• Drink plenty of water to help keep the body hydrated and flush out excess uric acid from the body.

• Blood test: Diagnosis is typically done through a blood test to measure the level of uric acid in the body.
• Urine Tests: To identify levels of uric acid and creatinine in urine, as well as for signs of kidney damage.
• Kidney Function Tests: To assess how well your kidneys are functioning.
• X-ray Imaging: To detect any signs of gout or other conditions that can cause high levels of uric acid.
• Joint Fluid Analysis: In joint fluid analysis, a sample of the fluid is taken from the affected joint and then analyzed for levels of uric acid. If the levels are too high, it indicates that there is an underlying condition causing hyperuricemia.

Possible complications of hyperuricemia include:

• Gout
• Kidney stones
• Hypertension
• Atherosclerosis
• Increased risk of cardiovascular disease.

• Eat more alkaline foods: Alkaline foods like vegetables and fruits can help neutralise the acidic environment in your body caused by high levels of uric acid. Eat more whole grains, legumes and nuts too to get more fibre which helps reduce symptoms associated with hyperuricemia.
• Take herbal supplements: Herbal remedies such as turmeric (Curcuma longa), ginger (Zingiber officinale) and guduchi (Tinospora cordifolia) are known to be effective home remedies for hyperuricemia as they help reduce inflammation and improve liver functioning to aid in digestion of proteins which leads to reduced production of uric acid in the body.
• Eat cherries: Eating cherries is another effective natural remedy for hyperuricemia as they contain antioxidants which help flush out the excess uric acid from the body.
• Use baking soda: Baking soda helps to neutralise the high levels of uric acid in the blood and thus can be used as a home remedy for hyperuricemia.
• Try apple cider vinegar: Apple cider vinegar helps to reduce high levels of uric acid in the blood and is a great home remedy for managing hyperuricemia naturally without any side effects or risks associated with medications or surgeries

In hyperuricemia, it is important to eat foods that are low in purines, such as most fruits and vegetables, whole grains, low-fat dairy products, and lean proteins.

Foods high in purines, such as organ meats, shellfish, anchovies, sardines, herring, mackerel and gravies should be avoided in cases of hyperuricemia. Other foods to avoid include alcohol (especially beer), sugary beverages and processed or refined carbohydrates.

• Dietary Changes: Eating a healthy balanced diet that is low in purine-rich foods such as organ meats and shellfish can help reduce levels of uric acid in the blood. Increasing intake of fruits and vegetables can also be beneficial.
• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce inflammation associated with gout or other conditions caused by high levels of uric acid. Some other medications may be prescribed to help lower uric acid levels in the bloodstream.
• Lifestyle Modifications: Exercising regularly can help reduce excess weight that may contribute to higher levels of uric acid in the bloodstream. Additionally, avoiding alcohol consumption and limiting intake of sugary drinks can also be beneficial for reducing uric acid levels.
• Uricase enzyme therapy: This involves injecting a form of the uricase enzyme into the blood, which breaks down uric acid into a more soluble form that can be excreted in the urine.
• Kidney transplantation: In some cases, when kidney disease is causing an accumulation of uric acid, a kidney transplant can be done to help improve the situation.
• Laparoscopic Surgery: This is a minimally invasive procedure that removes part or all of the kidneys to reduce uric acid levels in the body.
• Percutaneous Nephrolithotomy (PCNL): This procedure uses shockwaves to break up large stones in the kidneys caused by an accumulation of uric acid crystals and is often used as an alternative to open surgery for patients who have had recurrent kidney stones due to hyperuricemia.

To diagnose the condition and determine its cause, it is important to consult with a doctor specialising in Internal Medicine, Rheumatology, Nephrology, or Endocrinology.

The best medicines for hyperuricemia include allopurinol, probenecid, febuxostat, and colchicine.

• Allopurinol: It is the most commonly prescribed medicine for hyperuricemia and works by decreasing the amount of uric acid produced by the body.
• Probenecid: It works by increasing the excretion of uric acid in urine.
• Febuxostat: It is a newer medicine that inhibits xanthine oxidase and reduces uric acid production.
• Colchicine: It can also be used to reduce inflammation associated with gout attacks caused by hyperuricemia.

Recovery from Hyperuricemia typically takes several weeks to a few months, depending on the severity of the condition and how consistently an individual follows their treatment plan. With appropriate care and treatment, full recovery is possible.

• The results of treatment for hyperuricemia are not always permanent. Depending on the underlying cause and severity of the condition, lifestyle changes, medications, or other treatments may be needed to maintain healthy uric acid levels in the blood.
• In some cases, lifestyle changes may not be enough and lifelong medication therapy may be required.

• Post-surgical treatment guidelines for hyperuricemia may vary depending on the cause of the condition and the type of surgery that was performed.
• Generally, it is important to follow a healthy lifestyle that includes eating a balanced diet, exercising regularly, avoiding alcohol and sugary drinks, taking medications as prescribed by your doctor, and drinking plenty of fluids.
• Additionally, it may be beneficial to take certain supplements such as vitamin C or folic acid to help reduce uric acid levels in the blood. If your doctor recommends it, you may also need to have regular follow-up visits to monitor your uric acid levels.

Generally, treatments such as medications, dietary changes, and lifestyle modifications are affordable and can range from a few hundred to a few thousand rupees.

Surgery is also an option for some cases, but it is more expensive and may cost up to tens of thousands of rupees. Additionally, certain herbal remedies may be used for the treatment of Hyperuricemia at relatively low costs.

The most common side effects of medications used to treat hyperuricemia include:

• Nausea
• Vomiting
• Headache
• Dizziness
• Joint pain

Other less common side effects may include rash or itching, stomach pain, diarrhoea, or constipation.Some medications may also cause kidney problems.

If you are suffering from any complications relating to hyperuricemia then you should consult a doctor nearby as they can cause complications like gout, kidney stones, hypertension, etc. in which treatment course can range from a few months to years depending on the severity of the situation.