L'uric acid is a substance present in our blood, which derives from the degradation of nitrogenous bases, the bricks that make up the DNA present in our cells, like all animal or plant cells. The term uricemia indicates the concentration of uric acid in the blood. The main ones causes of high uric acid (hyperuricemia) are increased urate production or increased dietary intake, or reduced renal elimination. THE main symptoms of elevated uric acid are those of gout, and therefore joint pain with swollen and red joints, renal colic, fever.
High uric acid
Hyperuricemia is a fairly frequent condition, mainly linked to an increased cellular metabolism, to incorrect eating habits (diet rich in meat and alcohol) or to a reduced or defective elimination of uric acid. Let's see in detail what uric acid is and what are considered high levels.
Uric acid high values
What are the high urate levels? Uric acid levels can be measured both on a blood test, through the uric acid test, and on a urine sample. In the case of venous sampling it is important that the subject has fasted for at least 12 hours. We speak of uric acid as high as the uric acid values when they exceed 7.5 mg / dl (7.5 milligrams per deciliter) for men and 7 mg / dl (7 milligrams per deciliter) for women. Values higher than these are a symptom of high uricemia. If uric acid levels are measured on a urine sample, the sample must be collected over a whole day, ie 24 hours. Normal uric acid values in urine should be between 250 and 750 milligrams. Values above this are a symptom of hyperuricemia.
Uric acid: what it is, how and where it is produced
L'uric acid, or urate, it is a waste product of purine metabolism. The purines, mainly represents fromadenine and from guanine, they are nitrogenous bases, particular compounds that constitute, together with the pyrimidines thymine and cytosine, the molecules of DNA. Most of our cells have a short life and a very rapid turn-over, generating a huge amount of waste products that are degraded and processed by the body. The main product of purine breakdown is uric acid.
In addition, urates are also produced by the liver during the digestion of purine-rich foods introduced in the diet. Foods with a higher amount of purines are alcohol, fried foods, foods rich in fructose and meat, especially red meat such as pork. In any case, it is fair to clarify that most uric acid is produced endogenously, following cellular degradation and turnover, and only a small part depends on the diet in place.
Uric acid: functions
What is the function of uric acid? What is it for? The functions of uric acid are not yet fully defined. Recent medical studies have shown that uric acid in the right values plays an important antioxidant action and improves the body's immune response. In case of uric acid levels above normal levels, on the other hand, uric acid can have harmful effects on the body, precipitating in the joints and connective tissue in the form of crystals (gout) or accumulating in the kidney with deposition of urate crystals that can form stones and / or cause the onset of renal failure.
Uric acid: metabolism and elimination
The nucleoproteins contained in the human body are the substrate for the formation of DNA, essential for proper cell turnover. At the end of the life cycle of a cell, all the core proteins that are not reused by the body undergo a metabolic process that leads to the formation of uric acid to be eliminated.
The elimination of uric acid occurs through the kidneys which daily eliminate about 500 milligrams of uric acid through the urine, while another 200 milligrams are eliminated with the secretion of feces.
Uric acid: diet and nutrition
The first thing you need to do to decrease the values of uric acid is to follow a diet that is not excessively caloric and that is balanced, limiting the intake of foods rich in proteins and purines such as sausages, legumes, fatty fish, meats, xanthine derivatives such as tea and coffee, beer, wine and alcohol in general, carbonated drinks, and increasing the intake of fruits, vegetables, cheeses, milk and eggs all foods containing a low percentage of purine. It is essential to take an adequate amount of fluids in order to maintain a valid diuresis and promote the elimination of uric acid.
As already mentioned, however, it is rare that simple dietary education can bring uric acids back to normal, and it is often necessary to use drug therapies such as allopurnol, which we will deal with later in the article.
Causes of high uric acid
The causes that cause hyperuricaemia can be due to:
- neoplasms: some types of cancer including leukemia and lymphomas due to the antiblastin drugs used for their treatment which causes an increase in the production of waste products in the body;
- chemotherapy treatments. Cytotoxic drugs used to fight cancer increase the number of cells that die and increase the concentration of uric acid in the blood;
- psoriasis. Often this autoimmune disease affecting the skin is related to hyperuricemia, due to the flaking of the epidermal cells;
- glycogenosis type 1, an inherited enzyme defect that causes glycogen to build up in the liver and kidneys;
- kidney disease which reduce the functions performed by the kidneys to filter and eliminate waste substances through the urine;
- feeding with products rich in purines including anchovies, sardines, mussels, mackerel, sausages, liver, meat extract and game;
- abuse of alcoholic beverages;
- diabetes mellitus
High Uricemia Symptoms
People who have excess uric acid in their blood or urine may have several symptoms including:
- articolar pains
- swollen joints
- reddened joints
- renal colic
- renal failure with elevated urea and creatinine
Consequences of hyperuricemia
Prolonged accumulation of uric acid leads to the onset of:
- Gout. Gout is an inflammatory disease caused by the accumulation of uric acid crystals in the joints. Symptoms caused by this condition are swelling, swelling, pain and redness that occur on the affected part of the joint. The joints most affected by gout are the feet, ankles, knees, wrists, elbows, and fingers. The accumulation of uric acid in the joints leads to their deterioration in the long run, creating further pathologies such as osteoarthritis.
- Cardiovascular disorders. The uric acid that is carried through the blood vessels when it is in excess accumulates in the blood vessels causing them to harden, resulting in an increase in blood pressure and fatigue of the heart. Scientific evidence shows that high uricaemia is an additional risk factor for the development of cardiovascular diseases;
- Renal dysfunction. Excess uric acid in the body can cause kidney stones, known as uratic stones, which can block the urinary excretory passages and cause painful renal colic, as well as sudden decrease in kidney function.
- Cystitis. Hyperuricemia makes urine thicker, creating an environment conducive to the development of urinary tract infections.
- Dermatological disorders. Excess uric acid can cause skin changes, up to the deeper layers of the dermis, with the onset of itching and skin rashes.
High Uric Acid Remedies
What are the main remedies for high uricaemia? is there a specific therapy for hyperuricemia?
Given that the first action to be taken is proper nutrition and adequate hydration, this is often not enough to bring uric acid back to normal.
In the acute stages of gout, the most important thing is to remove the painful symptoms, using anti-inflammatory and analgesic drugs. The Fans (non-steroidal anti-inflammatory drugs) are the most commonly used drugs in acute gout attacks. Among these we find drugs based on diclofenac, ibuprofen or ketoprofen, naproxen, piroxicam which must be taken in the doses indicated by the attending physician and reported in the package leaflet, until painful symptoms decrease. Generally these symptoms tend to subside within 3-4 days of treatment.
For patients with heart disease or who have gastric disorders due to the use of non-steroidal anti-inflammatory drugs, a therapy based on colchicine. Colchicine has a strong anti-inflammatory and analgesic action and is usually taken with doses of three tablets a day for four days, then reduce the dose to two tablets for a week and arrive at the maintenance dose of one tablet a day to be taken for one week. variable period between two and five months, as a prophylaxis to avoid future relapses.
Once the acute attack has been resolved, it is necessary to act on the uric acid levels, lowering them until they are within the reference values.
In cases where hyperuricemia is associated with underlying pathologies, a correct diet is not enough to lower the uric acid levels to the values considered normal, but it is necessary to integrate an allopurinol-based drug therapy to the correct diet.
Allopurinol (best known trade name Zyloric) is a drug that is prescribed to reduce uric acid production and to prevent the onset of a gout attack. This drug should be taken in a dose of 300 milligrams per day, starting treatment with a daily dose of 100 milligrams per day for one week, in the second week it is necessary to increase the dose by another 100 milligrams, and so on until the dose of maintenance that allows you to keep uric acid levels below 6 milligrams per deciliter. If the uricaemia values continue to be high, the doctor may decide to increase the daily dose to be taken up to 800 milligrams.
In any case, any non-medicated drug should only be taken on the advice of the treating physician, who will specify the dose and duration of treatment.Tags: Storage diseases Laboratory medicine