Advantages and disadvantages of urine alkalinization in patients with hyperuricemia and gout / 中华内分泌代谢杂志

ABSTRACT

Gout is a metabolic inflammatory disease characterized by hyperuricemia. When serum uric acid concentration(sUA) is greater than 420 μmol/L, monosodium urate(MSU) crystals are formed and deposited in joints and connective tissues, resulting in acute gout arthritis. In addition to the concentration of urate, pH is also one of the factors affecting MSU deposition. Lowering pH can promote MSU crystallization. Urine alkalization can raise the pH to 6.2~6.9, which can increase the solubility of urate to prevent MSU deposition and the formation of uric acid stones. Commonly used clinical medications include citrate, bicarbonate, acetazolamide, tromethamine, etc. Among them, potassium citrate is the most commonly used alkali agent in clinical practice. However, due to adverse drug reactions, clinical medications need to be cautious. In addition to pharmacotherapy, dietary intervention has also become an important means of alkalizing urine. When sufficient attention is paid to the construction of a balanced diet, dietary intervention will become a safe and economical method for the treatment of gout, but the long-term efficacy has not been determined. This article discusses the advantages and disadvantages of urine alkalinization in the application of hyperuricemia and gout from aspects of pharmacological treatment and diet management, and provides a basis for proper medication use.