GOUT AND HYPERURICEMIA AS ADDITIONAL FACTORS OF DETERIORATION OF CARDIAC AND RENAL PATHOLOGIES

Currently, purine metabolism disorders (hyperuricemia and gout) are called one of the risk factors for the development of diseases such as coronary heart disease, arterial hypertension, metabolic syndrome, kidney pathology. The article shows the basic principles of treatment of purine metabolism disorders, taking into account diet and drug therapy. Schemes of prescribing the main anti-gout drugs with the recommended doses are given. It is emphasized that the main drugs for the treatment of acute gouty arthritis are colchicine, nonsteroidal anti-inflammatory drugs and glucocorticoids, and in their ineffectiveness – interleukin-1 inhibitors. The basic principles of dietary nutrition of this category of patients are given. Pay attention to a differentiated approach to the treatment of gout/hyperuricemia, taking into account comorbid cardiac and renal pathologies. It has been shown that an important step to improve the effectiveness of the treatment of hyperuricemia/gout in clinical practice is to improve the adherence of patients to the doctor’s recommendations. It is emphasized that xanthine oxidase inhibitors remain first-line drugs for the treatment of purine metabolism disorders. The advantage of these drugs over drugs that affect the excretion of uric acid, due to their antioxidant effect, which is especially important in patients with comorbid cardiac pathology. In case of intolerance to xanthine oxidase inhibitors, uricosuric drugs are indicated. In the hypoexcretory type of gout, the use of combined drugs is possible. Patients with severe gout in whom the target serum uric acid level cannot be achieved with any of the other available drugs at the maximum dose are shown to catalyze the oxidation of uric acid to allantoin. New uricosuretics are promising, which inhibit the reabsorption of uric acid by the kidneys by blocking its vectors. There are studies on the effectiveness of pro-, pre-, and synbiotics in these patients.