As for non-drug therapy,
Low calorie, low purine and alkaline foods should be eaten mainly to change bad habits. It is suitable for patients with chronic renal disease with mild blood uric acid. To give up smoking, alcohol and high purine food intake, reduce beverage intake, every day more than 2000 ml water to increase uric acid excretion, careful inhibits uric acid excretion of drugs (thiazide diuretics), avoid using elevated uric acid drugs. Some metabolic diseases are associated with hyperuric acid, so blood pressure, lipids, weight loss, and insulin resistance should be actively controlled.
Inhibiting uric acid production
Are commonly used in the treatment of high blood uric acid, xanthine oxidase inhibitors, inhibits purine from scratch, on renal failure caused by high uric acid hematic disease has good effect. The drug can quickly reduce the serum uric acid and no increase in uric acid excretion, can be used to control early, mid - high blood uric acid of patients with chronic kidney disease (CKD), and help to improve the kidney function. Starting from small doses, the initial dose is 50 mg per day, 2 to 3 times a day. Increase to 100 mg in 2-3 weeks and take it twice a day. Severe gout can be used daily to 600 mg. Maintain: 100 to 200 mg per adult, 2 to 3 times per day.
Small dose initiation reduces the burning sensation at the beginning of early treatment, and can avoid the hypersensitive response associated with severe leprositol. When kidney function drops, such as the Ccr < 60 ml/min, the recommended dose is 50 to 100 mg/d, and the Ccr < 15 ml/min is disabled. The adverse reaction is allergic reaction, gastrointestinal stimulation, rash, fever, liver damage, eosinophilic increase, bone marrow suppression, serious people can endanger life. Should be careful to monitor the blood routine, liver and kidney function during the use of medicine, if be uncomfortable, stop medicine in time.
The cloth pision him
It is an effective selective xanthine oxidase inhibitor of purines, which is good for diuretic acid, good tolerance, and can delay renal function decline. Suitable for renal insufficiency, to promote the uric acid excretion medicine has taboo (chronic kidney disease in patients with stage 3-5, urinary stones, etc), don't Piao alcohol allergy or intolerance of gout patients. Light, medium chronic kidney function does not need to adjust dosage, the recommended starting dose is 40 mg, once a day.
From gloucester for enzyme
Specificity of the enzyme is a kind of polyethylene glycol (peg), uric acid, uric acid can be broken down into soluble allantoin, hydrogen peroxide, and carbon dioxide, quickly reduce serum uric acid, and uric acid calculi. Patients with hyperuria that are still unable to meet the target of treatment after traditional diuretic acid treatment. At present, the dosage is 8 mg for injection and the iv infusion every 2 to 4. Use from gloucester enzyme treatment for 3 months, the patients serum uric acid concentration > 6 mg/dl, still and have - heavy infusion reactions in clinical recommendations to terminate from gloucester for enzyme treatment.
To promote the excretion of uric acid
By inhibiting the reabsorption of uric acid by the renal tubule, the uretic acid excretion is increased. Urinary uric acid excretion of > 6.54 mmol/d or patients who have formed uric acid stone should not be used. It is mainly composed of benzoprene Malone and propylene sulfonas.
Benzene bromide Malone
It inhibits the reabsorption of uric acid by the proximal convoluted tubule and completely inhibits urat-1 in the transshipment of uric acid. Severe kidney disease also can be taken, toxic effect is mild, have no apparent effect on liver and kidney function. Patients with chronic kidney disease, which can be used for Ccr > 20 ml/min, need not be reduced by 50 to 100 mg per day for adults with Ccr > 60 ml/min. Taking should be not less than drinking water during 1500-2000 ml/d prevent urinary stones, medication can take 2 weeks before baking soda or folic acid mixture, keep urine PH value between 6.2 to 6.9. Patients with chronic kidney disease should be properly controlled.
The uretic acid excretion is increased by inhibiting the uric acid salt anion transporter in the proximal renal tubule. The allergic and renal insufficiency of sulfonamide drugs. Initial dose for adults 0.25 g each time, twice a day, two weeks after gradually increased to 0.5 g each time, three times a day, total daily dose should not be more than 2 g, in principle, with the minimum effective dose, according to the patient's symptoms and uric acid level adjust the dosage. The drug is not suitable for the same as salicylic acid, antipyric acid, hydrochlorothiazide, nonsteroidal anti-inflammatory drugs, and oral lowering of sugar. When taking this medicine, you should drink enough water to prevent the formation of kidney stones. It is not recommended for children, elderly or peptic ulcers. Because the drug often interferes with many drugs in the renal tubule, the clinical use is less.
Chronic kidney disease patients with high uric acid hematic disease should pay attention to inpidualized principle, according to select drugs in patients with renal function, many drop uric acid drugs should be used in small doses gradually added amount, avoid cause gout, and long-term use in order to maintain the blood uric acid in the normal level.