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What happens if uric acid is very high?

Hyperuricemia occurs when there's too much uric acid in your blood. High uric acid levels can lead to several diseases, including a painful type of arthritis called gout. Elevated uric acid levels are also associated with health conditions such as heart disease, diabetes, and kidney disease.

healthline.com - Hyperuricemia: Symptoms, Treatment, and More - Healthline

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Is hyperuricemia common? Hyperuricemia occurs when there’s too much uric acid in your blood. High uric acid levels can lead to several diseases, including a painful type of arthritis called gout. Elevated uric acid levels are also associated with health conditions such as heart disease, diabetes, and kidney disease. Rates of hyperuricemia have risen sharply since 1960. The most recent significant study of hyperuricemia and gout found that 43.3 million Americans have the condition. Why hyperuricemia occurs Uric acid is formed when purines break down in your body. Purines are chemicals found in certain foods. This typically includes: red meat

organ meat

seafood

beans Normally, your body rids itself of uric acid when you urinate. Hyperuricemia occurs when your body either makes too much uric acid or is unable to excrete enough of it. It usually happens because your kidneys aren’t eliminating it quickly enough. Excess uric acid levels in your blood can lead to the formation of crystals. Although these can form anywhere in the body, they tend to form in and around your joints and in your kidneys. Your body’s defensive white blood cells may attack the crystals, causing inflammation and pain. Hyperuricemia symptoms Only about one-third of people with hyperuricemia experience symptoms. This is known as asymptomatic hyperuricemia. Although hyperuricemia isn’t a disease, if uric acid levels remain high, over time they can lead to several diseases. Gout Gout, sometimes called gouty arthritis, occurs in about 20 percent of people with hyperuricemia. A rapid drop in uric acid levels can also trigger gout. Gout can appear as isolated attacks, or flares. Some people experience chronic gout, which involves a number attacks occurring over short periods of time. Gout can affect any joint in your body, but flares often first appear in your large toe. Feet, ankles, knees, and elbows are also common sites of gout. Gout attacks tend to occur suddenly, often at night. The attacks peak in intensity in about 12 to 14 hours. Even untreated, attacks of gout usually subside within two weeks. Symptoms of gout may include: severe pain in your joints

joint stiffness

difficulty moving affected joints

redness and swelling

misshapen joints Tophaceous gout If you’ve had hyperuricemia for several years, uric acid crystals can form clumps called tophi. These hard lumps are found under your skin, around your joints, and in the curve at the top of your ear. Tophi can worsen joint pain and over time damage your joints or compress your nerves. They’re often visible to the eye and can become disfiguring. Kidney stones Uric acid crystals can cause a buildup of stones in your kidneys. Often, the stones are small and are passed in your urine. Sometimes, they can become too large to pass and block parts of your urinary tract. Symptoms of kidney stones include: pain or aching in your lower back, side, abdomen, or groin

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increased urge to urinate

pain when urinating

difficulty urinating

blood in your urine

foul-smelling urine If you also have a kidney infection, you may experience fever or chills. This buildup of urine is an ideal breeding zone for bacteria. As a result, urinary tract infections are common when you have kidney stones. Learn more: What is a urinary tract (bladder) infection? » Who is at risk for hyperuricemia Anyone can have hyperuricemia, but it’s more common in men than women and your risk increases with age. You’re also more likely to get it if you are of Pacific Island heritage or African-American. Several risk factors are associated with hyperuricemia: alcohol use

some medications, particularly medications for heart disease

lead exposure

pesticide exposure

kidney disease

high blood pressure

high blood glucose levels

hypothyroidism

obesity

extreme levels of physical activity

How hyperuricemia is diagnosed Your doctor may order blood and urine tests to measure creatinine levels, which determines kidney function, as well as uric acid levels. Blood is usually taken from a vein in your arm, typically on the inside of your elbow or on the back of your hand. Uric acid is normally found in your urine as your body excretes it. Your doctor may order a 24-hour urine collection if elevated levels of uric acid are found in your blood. This urine test is then repeated after a purine-restricted diet, which helps in determining whether: you’re eating too much high-purine foods

your body is making too much uric acid

your body isn’t excreting enough uric acid If you’re experiencing symptoms of gout, your doctor will want to test any fluid that has built up in your joints. This is done by using a fine needle to draw fluid from the joint. It will be sent to a lab where it’ll be examined for any evidence of uric acid crystals. The presence of these crystals indicates gout. Hyperuricemia treatment Your treatment for hyperuricemia will depend on its cause. If your hyperuricemia is asymptomatic, treatment isn’t recommended. In this situation, there isn’t any proven benefit to administering uric acid lowering therapies. If your hyperuricemia is tied to an underlying condition, the condition will need to be treated: Gout Gout is treated with one or more of the following medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help prevent or reduce the severity of gout. These include ibuprofen (Advil, Motrin IB), naproxen (Aleve, Naprosyn), and celecoxib (Celebrex), Colchicine (Colcrys) is often used to prevent or treat gout, particularly for people who don’t tolerate NSAIDs well. Probenecid helps lower uric acid levels by increasing urination and is used to help prevent gout attacks.

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Allopurinol (Zyloprim) and febuxostat (Uloric) help prevent gout by reducing the amount of uric acid in your bloodstream. Treatment for tophaceous gout is the same as for gout. If tophi become so large that they interfere with joint movement, damage surrounding tissue, or protrude through your skin, they may need to be surgically removed. During this procedure, an incision is made in skin overlying a tophus, and the tophus is removed. In rare instances of joint damage, joint replacement surgery may be considered. Kidney stones If you have kidney stones smaller than 5 millimeters (mm), your doctor may advise you to drink a lot of water and take over-the-counter pain medications until the stones pass. Kidney stones that are 5 mm or larger are less likely to pass on their own. Some doctors prescribe medications such as tamsulosin (Flomax) to relax the muscles in your urinary tract. This can make it easier and less painful to pass the stones. Additional techniques may be required. Extracorporeal show wave lithotripsy is a noninvasive procedure where ultrasonic energy or shock waves are directed through your skin at the kidney stone. The shock waves break the large stone into smaller pieces that can pass more easily through your urinary system. If the stones are greater than 10 mm, you may need to have them surgically removed. Ureteroscopic surgery is performed by passing a 2 mm scope through your urethra. It goes through your bladder and directly into the ureters, which are the tubes connecting your kidneys to your bladder. Your surgeon can then perform stone extraction. If the stones must be fragmented first, stents may be placed to aid the flow of urine. This can help relieve pain and keep the ureters dilated to allow for easier passage of fragmented or dissolving stones.

healthline.com - Hyperuricemia: Symptoms, Treatment, and More - Healthline

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