Therapeutic goals:
(1) alkalinize the urine
(2) reduce intake of purines
(3) reduce excretion of uric acid
(4) dilute the urine with fluid intake of 2.5 to 3 liters per day
The goal of urine alkalinization is a pH 7.0 to 7.2
(1) sodium bicarbonate or mineral water with a high concentration of bicarbonate
(2) potassium citrate or potassium+sodium citrate
(3) citrus juices
(4) calcium citrate if renal function is reduced
Reduced intake of purine-rich food:
(1) avoid meat, fish, yeast and other foods high in purine
(2) eat vegetables, cereal products, fruit, eggs and dairy products (ova-lacto-vegetarian diet)
Allopurinol is used to reduce uric acid excretion in the urine to < 4 mmol per day.
Since urine tends to become concentrated during sleep, fluid should be taken before going to bed and before each voiding at night.
Additional interventions:
(1) abstinence from alcohol (especially beer)
(2) avoid becoming dehydrated
(3) reduce body weight if obese
