Causes and Countermeasures for Hypouricemia.
Precautions in Daily Life
What daily precautions should be taken to prevent complications in people with hypouricemia? The followings are the points to pay attention in your daily lives.
People with Hypouricemia – Pay Attention to Exercise-Induced Acute Renal Failure and Urolithiasis
As of now, it is considered that low uric acid levels do not cause any disease. However, it can lead to some complications.
There are two complications: exercise-induced acute renal failure and urolithiasis. In Japan, the majority of people having hypouricemia present renal hypouricemia. Approximately 10% of the people with renal hypouricemia show symptoms similar to those of exercise-induced acute renal failure and approximately 7 – 10% experience urolithiasis.
Exercise-induced acute renal failure is a complication that shows symptoms including severe upper and lower back pain, nausea, vomiting, or decrease of urine volume after several hours to one day after an intense exercise. While there are some cases that require temporary dialysis, its prognosis is favorable, and patients can return to their normal lives with recovery of renal functions after one week to one month of treatment.
Precautions to Prevent Exercise-induced Acute Renal Failure
Although the cause of exercise-induced acute renal failure has not been identified yet, there are some hypotheses that suggest the effects of active oxygen or clogging of uric acid in the kidneys. Uric acid has antioxidative effects to suppress the effects of active oxygen that has increased excessively in the body. However, if uric acid levels are low, these antioxidative effects do not work sufficiently. The amount of active oxygen usually increases in the body after an exercise, but due to the lack of antioxidative effects of uric acid, the increased amount of active oxygen causes contraction of the renal arteries, inducing poor blood flow. This is considered to cause acute renal failure.
Another hypothesis is that exercise causes a rapid increase in the production of uric acid which is precipitated into the renal tubules, leading to tubular obstruction.
These hypotheses also have contradictory evidence. Since the treatment or prevention of exercise-induced acute renal failure still require clarification of its mechanism, further research is necessary.
Exercise-induced acute renal failure tends to occur when intense exercise is combined with some factors including dehydration or administration of NSAID*. People with hypouricemia should avoid short and intense anaerobic exercises (such as sprinting or strength training) and stay hydrated in order to prevent dehydration.
Precautions to Prevent Urolithiasis
Another complication that people with hypouricemia tend to show is urolithiasis. In the case of renal hypouricemia, the amount of uric acid excreted outside the kidneys is reduced. This increases the amount of uric acid excreted by the kidneys witch is thought to be the cause of the increase in kidney stones.
To prevent urolithiasis, stay hydrated in order to avoid making the urine too concentrated. In addition, try to reduce the amount of purine-rich foods and consciously choose a low-purine diet.
* Drug which has anti-inflammatory, analgesic, or antipyretic action