The relationship between high uric acid and renal function

High uric acid level is a metabolic disease caused by a metabolic disorder of purine in the human body, which leads to an increase in uric acid levels in the blood. The kidneys are very important metabolic organs in the human body. When high uric acid levels occur, many patients worry that it will have a certain impact on kidney function, thereby inducing more serious consequences. So, what is the relationship between high uric acid and kidney function?

The process of kidney metabolizing uric acid

The first is the filtration function of the glomerulus. Glomerular filtration is the first metabolism of uric acid in the human body. When the glomerular filtration function is reduced, it is a manifestation of renal insufficiency or renal failure, which will cause high uric acid levels. The second is the reabsorption of renal tubules. The reabsorption of renal tubules is based on the filtration function. When the reabsorption of uric acid by the human renal tubules is weakened, the human body can easily metabolize uric acid. Based on this principle, many methods of lowering uric acid have been invented, such as drug treatment. Allopurinol tablets can reduce the concentration of uric acid by inhibiting the reabsorption of uric acid by the renal tubules. It will cause changes in uric acid concentration.

Kidney damage caused by uric acid

There are mainly three types, namely chronic uric acid nephropathy, acute uric acid nephropathy and uric acid nephrolithiasis, which may overlap with each other.

1. Chronic uric acid nephropathy: The symptoms are insidious, manifested as decreased tubular concentrating function, increased nocturia, low specific gravity urine, microscopic hematuria, small amounts of proteinuria, low back pain, edema, hypertension, and gradually developing chronic renal insufficiency. After confirming chronic hyperuricemia, it is necessary to carefully analyze whether other diseases such as acute and chronic leukemia, polycythemia, multiple myeloma, hemolytic anemia, lymphoma, etc. are present. In addition, it is also necessary to consider whether hyperuricemia is caused by kidney disease. In chronic renal failure, the reduced excretion of uric acid may lead to elevated blood uric acid levels, but proteinuria is often more and gout rarely occurs.

2. Uric acid urinary stones: The concentration of uric acid in the urine accumulates and deposits to form urinary stones. Smaller stones are gravel-like and can be excreted with urine without symptoms; larger stones can obstruct the urinary tract, causing renal colic, hematuria, and complications such as urinary tract infection and hydronephrosis.

3. Acute uric acid nephropathy: It is more common in secondary hyperuricemia, and can also be seen in patients with hyperuricemia who fail to receive appropriate hydration therapy when they are given sufficient doses of drugs to promote uric acid excretion for the first time. Due to the sudden and significant increase in uric acid, a large amount of uric acid crystals are deposited in the renal tubules, causing extensive and severe obstruction of the renal tubules, manifesting as oliguria, anuria or acute renal failure.