Brother Li is 56 years old this year and has been suffering from gout for a long time, but he has always been unwilling to go to the hospital and has never restricted his diet.
Whenever gout flares up, he just takes some painkillers on his own, often citing, “Everyone has their fate, eat and drink what they should, why live in such pain?”
Recently, his gout attacks have been particularly frequent, the painkillers are not easing the symptoms, and he has even developed hematuria. When his children found out, they immediately called an ambulance for him, but he kept cursing on the way to the hospital, reluctant to go.
Upon arriving at the hospital, it was discovered through examination that Brother Li’s long-term high uric acid levels had led to kidney failure, and now the only way to sustain life is through dialysis.
This situation was hard for them to accept – it’s just gout, how could it lead to such serious kidney failure?
1. Persistently high uric acid levels, beware of kidney disease
Uric acid is a breakdown product of purine nucleotides in the body, with 20% obtained from food and 80% produced by cellular metabolism. Its metabolites are converted to uric acid in the liver, eventually excreted via the kidneys and intestines.
When purine metabolism in the body is disrupted or reduced, it leads to elevated blood uric acid levels, triggering the occurrence of hyperuricemia.
Gout occurs when blood uric acid reaches a certain level, uric acid crystals deposit in the joints, soft tissues, and kidneys, causing symptoms such as arthritis, skin lesions, and kidney damage.
Jiangxi Provincial Hospital of Traditional Chinese Medicine’s Huang Chenxi and Wu Guoqing pointed out that high uric acid levels primarily damage the kidneys by causing urinary tract stones and uric acid-induced renal parenchymal damage, both of which can coexist, mainly manifesting in three forms:
1. Acute uric acid nephropathy
Due to excessive accumulation of uric acid levels in the blood and urine, they deposit in the renal tubules and collecting ducts, leading to obstruction of the renal tubules, causing acute urinary obstruction, ultimately leading to acute renal failure. The main symptoms are lower back pain, acute oliguria/anuria, and the presence of uric acid crystals in the urine.
2. Uric acid urinary tract stones
When the uric acid concentration in the urine is oversaturated, it can deposit in the urinary system and form uric acid stones, with kidney stones being the most common.
When stones obstruct the urinary tract, it can cause kidney colic, hematuria, difficulty urinating, and in severe cases of acute obstruction, it can lead to acute kidney injury with symptoms such as fever, elevated creatinine levels, and renal hydronephrosis.
3. Chronic uric acid nephropathy
High uric acid levels can cause chronic interstitial nephritis, initially manifested as mild proteinuria, hematuria, impaired renal concentrating ability, increased nocturnal urination, and later progressing to impair normal kidney function, leading to chronic kidney failure and eventually progressing to uremia.
Among these three complications, chronic uric acid nephropathy is the most critical to pay attention to because of its high incidence and insidious onset, easily overlooked in the early stages and by the time symptoms become evident, it often has progressed to irreversible stages.
2. Eggplant as an accelerator for high uric acid?
Eggplant, a common vegetable at the dining table, has been circulating online with the claim that “people with high uric acid levels cannot eat eggplants.” Is this really true?
Whether a food item raises uric acid levels depends mainly on its purine content. Eggplant contains 14 mg of purine per 100 grams, making it a low-purine food that hardly affects uric acid levels.
In addition, eggplant is rich in vitamins, assisting in clearing rubbish and toxins from blood vessels, improving vascular elasticity, ensuring normal blood circulation, preventing blood clots, and thus aiding in preventing cardiovascular diseases.
Director Liu Aihua from the Rheumatology and Immunology Department of Beijing Hospital suggests that though eggplants have low purine content, patients with high uric acid levels should still pay attention to the cooking methods. It is generally not recommended to consume eggplants cooked with a lot of oil, such as braised eggplant; instead, steaming is recommended.
Reducing the intake of high-purine foods can help lower uric acid levels to some extent. When it comes to high-purine foods, many people think of animal organs, alcohol, and meats. In reality, the purine content of some vegetables may be higher than that of certain meats.
Especially with these 4 types of vegetables, high uric acid patients wanting to avoid kidney disease should consume in moderation:
Nori: The purine content in nori is even higher than that of pig liver, with 415mg of purine per 100g dried nori, making it a high-purine food that can elevate blood uric acid levels when consumed in excess.
Dried mushrooms: Dried mushrooms have high purine content as well, making them unfriendly for patients in the acute phase of gout attacks.
Asparagus: Xia Wenlong, a leading nutritionist from Zhejiang Lide Hospital, states that asparagus contains a high purine content of 500mg per 100g, even higher than some seafood; it is recommended to blanch before cooking.
Dried legumes: Wu Yihao, a resident physician from the Cardiology Department of the First People’s Hospital in Hangzhou, Zhejiang Province, cautions that raw beans have high purine content, but skinned tofu and soy milk have lower purine content, suitable for daily consumption in moderation.
3. If uric acid is within this range, do these 5 things
Associate Chief Physician Li Xin and Zhang Baoyu from the Center for Endocrine and Immune Diseases at Beijing Luihe Hospital affiliated with Capital Medical University explain: For patients with high uric acid levels combined with hypertension, hyperlipidemia, diabetes, or stroke, and uric acid levels ≥480 μmol/L or without associated diseases but uric acid levels of ≥540μmol/L, medication to lower uric acid is needed.
For asymptomatic patients with mild high uric acid levels, adjusting lifestyle is enough. Here are five things to do:
1. Reduce consumption of high-purine foods
Such as animal organs, shellfish, thick meat soups/broths, and red meat; try to consume them less or avoid them. Increase intake of fresh fruits and vegetables, eggs, fish, and beans; it is recommended to keep daily purine intake under <200mg.
2. Limit alcohol intake
For men and women, daily alcohol intake should be limited to <28/14g, beer, yellow wine, and spirits are not recommended. A 14g alcohol content is approximately 145ml of 12° red wine, 497ml of 3.5° beer, or 43ml of 40% distilled spirits.
3. Drink more water
For individuals with high uric acid and normal cardiac and renal functions, daily increased water intake is necessary, maintaining a daily urination volume of 2-3L is advisable while avoiding beverages with high sugar content like carbonated drinks and fruit juices.
4. Regular exercise
It is recommended to engage in at least 150 minutes of moderate-intensity aerobic exercise per week, about 30 minutes each session, no less than 5 times a week, keeping the heart rate between 50-70% of 220 minus the individual’s age. Avoid vigorous exercise to prevent gout attacks.
5. Control weight
Obesity is also one of the triggers for gout attacks. It is advised for obese individuals to lose at least 1.5-3kg per month, maintaining a BMI between 18.5-23.9, with males and females keeping their waist circumference below <90/80cm.
Hyperuricemia can have a significant impact on health, so never think that high uric acid levels are harmless. Once uric acid elevation is detected, actively cooperate with doctors to adjust lifestyle, and if necessary, take medication to control the condition.
References:
[1] “What do you know about hyperuricemia and gout?” Xie Yun Kidney, December 31, 2023
[2] “Unbelievable! These vegetables have higher purine content than meat!” Health Times, April 8, 2023
[3] “Discovered high uric acid during a check-up, should medication be taken? Will it definitely lead to gout?” Health China, December 2, 2023
