What causes gout? What is the best way to prevent gout?

Gout is usually caused by hyperuricemia. This disease causes soreness and pain in the joints, seriously affecting the patient's health and daily life. What exactly causes gout? What are the best ways to prevent gout?

1. Secondary gout

Refers to a clinical manifestation secondary to other disease processes and may also be caused by certain drugs. Myeloproliferative diseases such as leukemia, lymphoma, multiple myeloma, polycythemia, hemolytic anemia and cancer can lead to accelerated cell proliferation, increased nucleic acid conversion and increased uric acid production. Malignant tumors cause massive cell destruction after radiotherapy and chemotherapy, and nucleic acid conversion also increases, leading to increased uric acid production. Kidney diseases including chronic glomerulonephritis, pyelonephritis, polycystic kidney disease, lead poisoning and advanced hypertension can cause impaired glomerular filtration function, which can reduce uric acid excretion and lead to increased blood uric acid concentration. Drugs such as thiazide diuretics, furosemide, ethambutol, pyrazinamide, low-dose aspirin and niacin can competitively inhibit the excretion of uric acid by the renal tubules and cause hyperuricemia. In addition, renal transplant patients who take immunosuppressants for a long time may also develop hyperuricemia, which may be related to the fact that immunosuppressants inhibit the excretion of uric acid in the renal tubules.

2. Primary gout

It is mostly hereditary, but clinically only 10% to 20% of people have a family history of gout. Excessive uric acid production accounts for 10% of the causes of primary hyperuricemia. The main causes are purine metabolic enzyme defects, hypoxanthine guanine phosphoribosyltransferase (HGPRT) deficiency and hyperactivity of phosphoribosyl pyrophosphate (PRPP) synthetase. Primary renal reduced uric acid excretion accounts for about 90% of primary hyperuricemia. The specific pathogenesis is unclear and may be a multi-gene genetic disease, but organic renal diseases should be ruled out.

prevention

For patients with asymptomatic hyperuricemia, prevention of gout attacks is mainly based on non-drug treatment, including diet control and abstinence from alcohol, and avoiding the use of drugs that increase blood uric acid such as diuretics, low-dose aspirin, compound antihypertensive tablets, pyrazinamide, nifedipine and propranolol. If blood uric acid is still higher than 9 mg/dl after dietary control, uric acid-lowering drugs can be used. For patients in the intermittent period who have experienced acute gouty arthritis, recurrence of gout should be prevented. The key is to control the blood uric acid level to the standard through diet and drug treatment. In addition, they should pay attention to avoid strenuous exercise or injury, control weight, drink plenty of water, and alkaline urine for a long time.