Patient/caregiver was educated on indications for low purine diet as follows:

• Stress:
  • The steroid hormone cortisol essentially helps with stress relief and management. Chronic unrelieved stress in individuals can result in increased secretion of cortisol, as a measure for stress management.
  • Increased cortisol secretion in the body can result in the side-effect of protein breakdown. Increased protein breakdown in the body results in increased production of purines, which upon metabolism yields increased uric acid production.
  • This can result in hyperuricemia with increased risk for gout & uric acid kidney stones.
  • Limiting purine intake for patients with chronic poorly controlled stress can result in reduced uric acid production, reduced risk for uric acid renal stone formation, and reduced risk for gout activation, joint inflammation & damage.
• Diuretic use:
  • Uric acid produced in the body is soluble in water, dissolved in body fluids, and is ultimately excreted in the urine.
  • Individuals using high doses of diuretics can have large volumes of fluid loss in urine. Individuals low on fluids can have an issue with dissolving and excreting the uric acid produced.
  • This can result in progressively increased retention of uric acid in the body and hyperuricemia with increased risk for gout & uric acid kidney stones.
  • Limiting purine intake for patients taking high dose of diuretics can result in reduced uric acid production, reduced risk for uric acid renal stone formation, and reduced risk for gout activation, joint inflammation & damage.