October 12, 2022 Author : Sara Leite What is uric acid? Uric acid is a product of the metabolism of compounds called purines , which are present in our body and also in the food we eat. They are part of the composition of DNA (deoxyribonucleic acid) and RNA (ribonucleic acid). They are present in foods especially in those with high protein content . Under physiological conditions, there is a balance between the uric acid produced in the body and its excretion through the kidneys (in the urine) , which allows blood uric acid levels to remain within normal values, that is, below 6 .8 mg/dL. However, that balance can be altered, causing an increase in uric acid levels in the blood. Causes of high uric acid The high levels of uric acid in the blood ( hyperuricemia ) can be due to an increase of its production in the body, a decrease of excretion, or a combination of the two processes, based on several causes : Increased intake of purine-rich foods; Changes in renal function; Genetic enzymatic defects; Accelerated cell proliferation/destruction, as occur in some neoplasms; Effect of drugs that interfere with renal function, such as thiazide diuretics. Consequences of high uric acid Hyperuricemia, a cardiovascular risk factor Recently it has been found that high uric acid is a cardiovascular risk factor , especially in people who already have other cardiovascular diseases, hypertension or diabetes. Gout One of the most well-known consequences of hyperuricemia is gout. Gout is an accumulation of uric acid crystals in the joints, which results in their inflammation (arthritis). Local pain and sometimes fever are characteristic symptoms. Gout is more common in men aged 40-60 years. The joints most often affected are those from the first toe. However, not all people with high uric acid develop gout, and not all people with gout have high uric acid during crisis. Most people with high uric acid are asymptomatic. If you have symptoms suggestive of gout, make an appointment with your doctor so that he can make a definitive diagnosis and prescribe the appropriate treatment with medication aimed to relieve the symptoms and, thus, shortening the crisis period. After this acute phase it is also important to talk to your doctor so that he can decide whether chronic treatment is needed to lower uric acid levels. Kidney stones Another place where excess uric acid can build up is the kidney, giving rise to stones ( urolithiasis ). Low back pain and blood in the urine are the main symptoms in this case. Urolithiasis is not just due to hyperuricemia, there are other types of kidney stones, which are not related to high uric acid. I have high uric acid, now what? High uric acid alone may not warrant pharmacological treatment. However, only the doctor can determine what needs to be done. Make an appointment with your doctor to assess the presence of other comorbidities and the need for treatment. Attention! Do not self-medicate. Some medications can contribute to the increase in uric acid. If in doubt, talk to your doctor. Also, follow these recommendations: Avoid overweight; Practice physical exercise regularly; Avoid drinking alcoholic beverages, especially beer; Drink water in adequate amounts; Eat a varied diet, low in purine-rich foods. Some purine-rich foods to be reduced or avoided are: Meat; Sugary foods and drinks; Alcoholic beverages; Legumes such as beans, chickpeas, peas and lentils; Some fish and shellfish such as anchovies, sardines, tuna, cod, herring, salmon, haddock, scallops, mussels. Remember that Gout is not a disease of kings and rich people. This old idea was justified by the foods related to the disease and the eating habits of the time. With the improvement of socioeconomic conditions and the increase in average life expectancy, the prevalence of hyperuricemia and gout has increased in all population groups and this trend is expected to continue. Sources Bursill D, Taylor WJ, Terkeltaub R, Kuwabara M, Merriman TR, Grainger R, et al. Gout, hyperuricemia, and crystal-associated disease network consensus statement regarding labels and definitions for disease elements in gout . Arthritis Care Res 2019;71:427-34. White J, Sofat R, Hemani G, Shah T, Engmann J, Dale C, et al. Plasma urate concentration and risk of coronary heart disease: a Mendelian randomisation analysis . Lancet Diabetes Endocrinol. 2016;4:327-36. Kedar E, Simkin PA. A perspective on diet and gout . Adv Chronic Kidney Dis 2012;19:392-7. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
