At present, hyperuricemia in China shows a trend of high prevalence, youthfulness, higher male than female, and higher coastal than mainland. (A) Why is my uric acid high? The level of blood uric acid is determined by the balance between uric acid production and excretion. Hyperuricemia can occur because of excessive uric acid production, low uric acid excretion or both. Uric acid is the end product of purine metabolism, and high purine (seafood, animal offal, meat products, heavy beer consumption, etc.), high-protein foods and alcohol consumption are risk factors for hyperuricemia. Uric acid is excreted by the kidneys in 60% to 70% of cases. In patients with renal insufficiency, blood uric acid can be increased to some extent because of the reduction of uric acid secretion by the proximal tubules. In addition, the blood uric acid level is higher in mental workers than in manual workers, higher in men than in women, and higher in obesity than in people with normal body size. (B) What will happen if the uric acid is high? High uric acid has various hazards and can greatly increase the risk of developing metabolic syndrome, type 2 diabetes, hypertension, cardiovascular disease, chronic kidney disease, and gout. Increased blood uric acid levels can lead to acute uric acid nephropathy, chronic uric acid nephropathy and kidney stones, which can add to the problem for patients with existing underlying kidney disease. High uric acid is the most important biochemical basis and the most direct cause of gout. Gout refers specifically to acute characteristic arthritis and chronic gout stone disease, which can be complicated by renal lesions, and in severe cases, joint destruction and impaired renal function. (C) Do I need to treat my high uric acid? When blood uric acid is higher than 420μmol/L (male); 360μmol/L (female), intervention therapy is needed, and the goal of control is <360μmol/L. For patients who have had gout attacks, it is more important to control below 300μmol/L. Treatment of hyperuricemia is divided into lifestyle guidance and medication: (1) Lifestyle: low purine diet; drink more water and moderate alcohol; adhere to exercise and stay away from obesity. Lifestyle modifications should not be underestimated and can often achieve twice the effect with half the effort. (2) Drug therapy: alkalinize urine (sodium bicarbonate); inhibit uric acid synthesis (allopurinol, febuxostat); increase uric acid excretion (benzbromarone, propofol, etc.). Different patients are suitable for different drugs, the specific application must follow the doctor's instructions! In addition, the long-term application of some drugs may cause uric acid to rise: thiazide and tab diuretics, niacin, small doses of aspirin, etc., at this time, you need to weigh the pros and cons with your doctor before using it. Do you understand all the things about uric acid?