Uric acid - is the end product of purine bases conversion reactions that form the basis of DNA and RNA nucleotides synthesized mainly by the liver and kidneys output.It represents a heterocyclic compound of carbon, oxygen, nitrogen and hydrogen.
uric acid levels, as measured by the biochemical analysis of blood, says health.Shifts in the blood content of this product in exchange upwards as downwards, depends on two processes: the formation of acid by the liver and kidneys its clearance time, which may vary due to various pathologies.
norm uric acid
|Category||Norma, umol / l|
|Children under 12 years||120-330|
|Women up to 60 years||200-300|
|Men under 60 years||250-400|
|women from 60 years||210-430|
|Men aged 60||250-480|
|norm for women from 90 years||130-460|
|norm for men from 90 years||210-490|
analysis of this kind of analysis is given as to assess the state of health in the course of the clinical examination, and in the presence of certain diseases
Preparing to study is to refrain from eating for eight hours, ie,on blood samples the patient comes fasting.It is advisable to take the tests before taking any medications (antihypertensives, etc.).For 1-2 days before analysis should completely eliminate alcohol, do not get involved in food rich in proteins and purines, and avoid physical overload.
To investigate the venous blood is taken - an indicator is defined in the serum.Usually, the result will be ready in 1 day.
Causes of elevated uric acid
already at stage 2 hypertension there is an increase of uric acid.Hyperuricemia causes damage to the kidneys, contributing to the progression of the underlying disease (see. The review of drugs against high blood pressure).Against the background of antihypertensive therapy serum uric acid may come to normal without specific therapy.If such dynamics is not observed, it is recommended the observance of special diets (see. Below) and increased physical activity, with further therapy hyperuricemia.
When uric acid is elevated in gout, the reason is the excessive formation of purine bases.Gout is most kidneys suffer from the gradual formation of renal failure, as well as joints, but the changes are not as active in them.The degree of pathological changes correlated with the level of uric acid - the higher, the greater the impressed kidneys.In addition, hyperuricemia contributes to the development and progression of atherosclerosis, the defeat of the arterial wall, resulting in people with gout are more prone to cardiovascular disease.
Diseases of endocrine organs: acromegaly, hypoparathyroidism, diabetes.
When hypoparathyroidism another characteristic indicator is the increased blood calcium is mobilized from the bones.
high level of blood sugar and giperinsulyarnyh hormones in diabetes leads to pathological changes of many kinds of exchanges, including the destruction of the nuclear material of cells, leading to a secondary increase uric acid levels regardless of renal function.
Acromegaly is caused by excess growth hormone synthesizing and appears disproportionate increase in body parts.The pathology is accompanied by metabolic disorders of purine nucleotides, respectively, hyperuricemia.
increased weight and often accompanies gout and diabetes, and hypertension.There is a concept of the metabolic syndrome, a particularly topical in recent decades, obesity + hypertension + diabetes.Each of these pathologies promotes hyperuricemia.
Elevated levels of lipoprotein and cholesterol
frequent precursor to overt clinical manifestations of gout and HA is an asymptomatic increase of these two components of the lipid profile.Atherosclerotic changes in the arteries, relating to different vascular beds.Uric acid accelerates the oxidation reaction of low density lipoproteins and lipid peroksigenatsiyu.Generated thus oxidative stress contributes to the progression of atherosclerosis.In addition, uric acid is involved in platelet aggregation and adhesion, increasing the risk of coronary thrombosis.
kidney diseases, urolithiasis
Uric acid is a substance kamneobrazuyuschim and promotes the formation of kidney stones.Decreased renal excretion of uric acid in a number of pathologies: polycystic kidney disease, renal failure, nephropathy in the background of lead poisoning, acidosis and toxemia of pregnancy.
In this case, in addition to the collapse of the blood components, takes place the disintegration of tissue components with higher levels of purine bases.Hyperuricemia is characteristic of polycythemia, leukemia, B12-deficiency anemia, congenital and acquired hemolytic anemia.
Asymptomatic increase the level of uric acid
Every fifth inhabitant of Russia and Belarus has been an increasing level of metabolic products in the blood without clinical pathology.Based on a number of epidemiological and prospective studies of this condition is considered as an independent, powerful and modifiable risk factor for cardiovascular and subsequent mortality.
- diseases that occur with a massive collapse of the tissue, for example, burn shock.Against the backdrop of kidney failure increases the time renal excretion of metabolic products.
- Syndrome Lesch-Nai Han, a genetic disease in which the body accumulates purines.Besides hyperuricemia, elevated levels found in acid urine.
- Down syndrome on the background of a violation of purine metabolism.
- Erectile Dysfunction.Increased purine metabolism product in the blood up to 6 times increased risk of developing erectile dysfunction.
Non-specific factors leading to hyperuricemia
- Application number -Furosemid drugs, aspirin, phenothiazines, Theophylline, Adrenaline and others.
- diet rich in purine bases.It is known that the second name of gout - a disease of aristocrats with an excess of meat, fish, red wine by-products in the diet, ieproducts containing large amounts of purines.
- Drinking alcohol, especially beer and red wines that are rich in purines.In addition, alcohol adversely affect kidney and liver function, which also contributes to hyperuricemia.
- Long-term diets that result in violation of renal excretory function.
- excessive exercise leads to hyperuricemia due to the increased consumption of protein, ie,its decay.
Symptoms of elevated levels of analysis
When increased uric acid in the blood, symptoms of this condition are always specific, depending on the underlying causes of disease, but there are specific symptoms that allow suspect hyperuricemia:
- Adults :
- fatigue Chronic fatigue
- specific symptoms associated with the basic pathology
- children : bright red spots diathesis in her arms and cheeks.
positive effect of hyperuricemia
Paradoxically, the high levels of purine metabolism product in the blood, according to some researchers, the beneficial effect on the body and allows you to adjust some pathological conditions:
- Numerous studies 60-70.confirmed a high level of intelligence and responsiveness in patients with acute hyperuricemia.Acid chemical structure similar to trimethylated xanthine caffeine, therefore, is believed to be able to improve performance.
- Elevated levels of acid prolongs life by acting as an antioxidant, blocking peroxynitrite, superoxide and oxidative reactions catalyzed by iron.Transfusion of uric acid increases the antioxidant activity of blood serum and improves endothelial function.
- Uric acid - is a strong neuroprotective agent, an inhibitor of neuroinflammation and neurodegeneration, reducing the risk of Parkinson's disease and Alzheimer's disease.
However, this positive effect is observed in an acute increase in acid in the blood.Chronic hyperuricemia leads to endothelial dysfunction and promotes oxidative process.
What to do in the analysis increased
Detection of high levels of uric acid in the blood - is the first step for further diagnostics to establish the root cause of this condition.The fundamental is to treat the underlying pathology with parallel treatment of hyperuricemia.
- Diet at an elevated uric acid includes a decrease in the proportion of protein products in the diet: meat, canned meats and soups, meats, herring, anchovies, sardines, coffee, chocolate, beans, mushrooms, bananas and alcohol at the same time increasing the share of fruit and vegetables,of dairy products, eggs, cereals, grains.Recommended broth hips and bran.
- struggle with being overweight.Often the normalization of weight hyperuricemia pass without specific treatment.
- Increasing the daily fluid intake to 2-3 liters.You can drink clean water or diluted by half with water, fruit, vegetable juices, fruit drinks.
All drugs are used strictly according to the doctor's prescription and under his control with regular measurements of acid in the blood and urine.
accelerates the removal of acid by the body in the urine.Since some of them increase the concentration of uric acid in the blood, and are contraindicated in a number of pathologies (gout and other), the purpose of this group of drugs is strictly performed individually and a short course of the control parameters of blood and urine.
Allopurinol inhibits the synthesis of uric acid in the liver by inhibiting the enzyme xanthine oxidase.Treatment of long-term (2-3 months), requires compliance with impeccable reception multiplicity.Analogs - Milurit, Zilorik, Foligan, Allopur, Prinol, Apurin, Atizuril, Gotikur, Uridozid, Ksanturat, Uriprim.
drug that affects renal function.Provides uricosuric effect, inhibiting absorption of acid in the proximal renal tubules, as well as by inhibiting the enzymes involved in purine synthesis.Analogs - Hipurik, Normurat, Dezurik, Eksurat, Azabromaron, Maksurik, Urikozurik, Urinorm.
Enhances acid secretion through the urinary system, especially in the initial stage of the treatment of gout.Analogs - Anturidin, Pirokard, Enturan, Sulfazon, Sulfizon.
Inhibits reabsorption of uric acid in the kidney tubules, thus reducing its concentration in the blood.
Effective decoctions of birch buds, nettle and cranberry sheet, which should be taken 1 cup twice a day for a month.
Reduced uric acid - pathological reasons
- hereditary deficiency of xanthine oxidase, which is formed when uric acid by the kidneys and excreted in the form of intermediate products of metabolism - xanthine.Xanthine not displayed completely, partly being postponed in skeletal muscle and kidney.
- Hereditary purine nucleoside phosphorylase deficiency - a condition where the purine bases are formed.
- acquired ksantinoksidzy drawback associated with taking allopurinol and liver diseases.
- Renal hypouricemia on background URAT1 GLUT9 and mutation of genes that control the proteins responsible for acid reabsorption in the proximal renal tubules.
- increase in extracellular fluid at high doses intravenously infused drugs, as well as on the background of polydipsia - strong thirst.
- Cerebral syndrome, in which there is hyponatremia, leading and hyperuricemia.
- Parenteral nutrition - specific power is directed at maintaining vital functions and, of course, does not contain purines.
- HIV infection, in which uric acid deficiency occurs on the background of the brain lesions.
- Cancer on the background of protein deficit and purine bases.
- enterocolitis due to malabsorption of protein intestinal epithelium.
- In early pregnancy, when increasing the total volume of circulating blood, and uric acid is diluted by the increased volume of the aqueous portion of the blood.
Non-specific factors leading to hypouricemia
- Nizkopurinovaya restricted diet of meat, fish.This situation can occur in low-income people or those who intentionally observes these restrictions.
- Abuse of tea and coffee, which have a diuretic effect and contribute to the removal of acid from the body.
- Supplementation: losartan, of salicylate groups, estrogen, trimethoprim, glucose, etc.
Symptoms of low levels of uric acid
- Loss of skin sensitivity;.
- visual impairment, hearing the fall;
- Asthenia - mood swings, tearfulness, fatigue, uncertainty, memory impairment;
- In severe cases - paralysis or even death due to asphyxiation, multiple sclerosis, multiple lesions of the nervous tissue.
How to increase uric acid
After finding the causes of the state of exception and serious pathologies can increase the show of blood, normalize the consumption of protein.The daily diet based on 1 g protein from 1 kg women 1.7-2.5 g protein per kg for males and at least 1.5 g protein per kg body weight in children.