From the Guidelines
Hyperuricemia is often asymptomatic until uric acid levels become significantly elevated, at which point it can cause symptoms such as sudden, severe joint pain, kidney stones, and kidney problems, as noted in the 2012 American College of Rheumatology guidelines for management of gout 1. The symptoms of hyperuricemia can be varied and may include:
- Sudden, severe joint pain, typically in the big toe, along with redness, swelling, and tenderness
- Joint pain in ankles, knees, elbows, wrists, and fingers
- Tophi, which are hard deposits under the skin
- Kidney stones
- Kidney problems, such as chronic interstitial nephropathy Many people with high uric acid levels remain asymptomatic until levels become significantly elevated, at which point symptoms can develop rapidly 1.
Causes and Risk Factors
Hyperuricemia occurs when the body either produces too much uric acid or the kidneys cannot efficiently remove it, often influenced by genetics, diet, and certain medications, as discussed in the 2012 American College of Rheumatology guidelines 1.
Management and Treatment
To manage high uric acid, medications like allopurinol or febuxostat can be used, along with lifestyle changes such as maintaining a healthy weight, limiting alcohol consumption, reducing purine-rich foods, staying hydrated, and exercising regularly 1. It is essential to note that the management of hyperuricemia should prioritize reducing uric acid levels to prevent the formation of urate crystals, which can cause symptoms and damage to joints and kidneys, as emphasized in the 2012 American College of Rheumatology guidelines 1.
From the Research
Symptoms of Hyperuricemia
The symptoms of hyperuricemia, or elevated uric acid levels, are not directly stated in the provided studies. However, the following information can be inferred:
- Hyperuricemia is a precipitating factor for gout and renal calculi, as well as a strong risk factor for Metabolic Syndrome and cardiovascular disease 2
- High plasma uric acid concentration can lead to monosodium urate (MSU) crystal deposition in joints and soft tissues, causing acute and chronic inflammation 3
- Untreated or improperly treated gout can lead to chronic manifestation of the disease, including persistent inflammation, increased number of flares, development of tophi, and structural joint damage 3
- Gout is a progressive, painful, debilitating form of inflammatory arthritis caused by factors that elevate the concentration of serum uric acid (sUA), leading to hyperuricemia (sUA >6.8 mg/dL) 3
Associated Conditions
Some associated conditions and risk factors for hyperuricemia include:
- Gout attacks, which can occur in patients with hyperuricemia, especially during the first two months of treatment with febuxostat or allopurinol 4
- Metabolic Syndrome and cardiovascular disease, which are strongly associated with high plasma uric acid concentration 2
- Renal calculi, which can be caused by high plasma uric acid concentration 2
- Higher waist circumference and BMI, which are associated with higher insulin resistance and leptin production, and can reduce uric acid excretion 2
Treatment and Management
Treatment and management of hyperuricemia typically involve reducing serum uric acid levels to <6 mg/dL, which is below the saturation point of MSU (6.8 mg/dL), to inhibit formation of new crystals and to promote dissolution of existing crystals 3. Some treatment options include: