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hyperuricemia and nephropathy

2017-03-03 11:01

In recent years, with the increase in the proportion of animal protein in the dietary structure of our residents, the population of hyperuricemia is also increasing. High uric acid can not only lead to gout, stones and acute and chronic renal failure, recent studies have shown that high uric acid on the heart, kidney and other organs have a direct pathogenic effect.

2/3 of uric acid produced daily by the kidneys excreted by the kidneys, 1/3 in the intestine. Normal blood uric acid concentration maintained at 200 ~ 450μmol / L (3.5 ~ 7.5mg / dl). The cause of hyperuricemia can be attributed to:
 

1. uric acid intake increased: some foods in food rich in purine, if too much intake can cause uric acid blood concentration increased
 

2. uric acid metabolism in the body abnormalities: the body involved in uric acid metabolism of the lack of enzymes, leading to uric acid metabolic process interrupted.
 

3. Reduce the excretion of uric acid in the kidneys: When the renal function is reduced, the excretion of uric acid is reduced and the uric acid concentration is increased.
 

Blood uric acid determination: fasting 8 hours or more. Drinking water, diuretics can affect the level of serum uric acid.

Some patients only in the laboratory found that elevated uric acid, no specific clinical manifestations, known as "asymptomatic hyperuricemia", such patients are often combined with obesity, hypertension, hyperlipidemia, diabetes, arteries Hardening, coronary heart disease and other diseases and complications, these factors will increase kidney damage. While other patients can be expressed as gout, kidney stones, if recurrent, will gradually appear renal dysfunction.

Clinical classification:
 

1. acute uric acid nephropathy: when the acute onset of hyperuricemia, a large number of uric acid into the renal tubular precipitation, often leading to acute renal failure, manifested as oliguria renal failure.
 

2. chronic uric acid nephropathy: the incidence of more hidden, the general clinical symptoms are not obvious, there may be high blood pressure, edema, low back pain. The kidney is mainly manifested as interstitial renal damage. May have increased nocturia, polyuria, urine decreased. Can also be intermittent small amount of proteinuria (generally not more than ++) and microscopic hematuria. As the disease progresses, persistent proteinuria may occur.
 

treatment:

1. mild hyperuricemia: mildly elevated, asymptomatic patients try to use non-drug method to control the level of uric acid in the normal range, such as drinking plenty of water, to avoid the high purine diet.
 

2. Chronic hyperuricemia: For uric acid> 600μmol / L (10mg / dl, female) and uric acid> 780μmol / L (13mg / dl, male) patients should be given uric acid treatment.

prevention:

It is important to control the intake of high purine food. Strict no purine diet can reduce blood uric acid levels by 15% to 20%. It is generally considered that the content of purine is the highest in the animal's internal organs, broth and beer, followed by most of the fish, shellfish, meat and poultry. Asparagus, cauliflower, green beans, spinach, mushrooms and peanuts are more. While milk, eggs, rice and noodles and most of the other vegetables purine content is low. Many fruits and vegetables contain a small amount of potassium, potassium can promote the excretion of uric acid in the kidneys, may be appropriate to eat some. In addition, more water, weight control, is strictly prohibited overeating for the reduction of hyperuricemia also play a role in the occurrence.

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