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Centres of Excellence -> Endocrinology and Diabetes -> Hyperuricemia/Gout

Hyperuricemia/Gout (high uric acid level)

Hyperuricemia represents the finding of an elevated level of urate or uric acid in the blood, while gout is the name for diseases or conditions that arise as a result of hyperuricemia. In the general population, the prevalence of hyperuricemia is about 25% and gout is 2%-6%. Hyperuricemia occurs due to disorders of uric acid metabolism, which includes its increased formation, impaired elimination by the kidneys or a combination of the above conditions.

When does hyperuricemia occur?

It most often occurs with:

  • diet rich in building materials from which uric acid (purines) is formed, i.e. excessive consumption of red meat
  • with increased consumption of alcoholic beverages
  • in patients with malignant tumors, during treatment with chemotherapy and radiation
  • with muscle breakdown
  • some genetic hereditary diseases
  • chronic renal failure
  • decreased thyroid function (hypothyroidism)
  • extreme diets
  • use of some medicaments (salicylates, diuretics)
  • poisoning
  • excessive intake of vitamin C, etc.

Hyperuricemia is also a biochemical marker of numerous metabolic, inflammatory-degenerative and hemodynamic disorders, such as insulin resistance, diabetes, obesity and metabolic syndrome.

Gout
Accumulation of uric acid in the joints leads to joint inflammation

Clinical presentation

In the clinical presentation, we distinguish:

  • asymptomatic hyperuricemia
  • symptomatic hyperuricemia

In the asymptomatic form, there is only laboratory evidence of elevated blood urate concentration.

In case of symptomatic hyperuricemia, uric acid crystals are deposited in the drainage system of the kidneys with the development of kidney stones and impaired renal function.

The deposition of uric acid in the joints leads to inflammation of the joints (uric arthritis). Similar problems occur with deposition in the tendons. The big toe is typically affected, which is swollen, red and painful, but the entire foot can be affected, as well as other joints with symptoms ranging from pain to inability to move.

Diagnosis and treatment

The basis of the diagnosis is a specialist examination, laboratory tests and other tests according to the indications. Treatment includes the elimination of the causative factor of hyperuricemia with medication and instrumental therapy.

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