Correspondence (letter to the editor): Regulation by Means of Diet/Nutrition

Concerning non-medicinal measures, the authors (1) do quote the guidelines of the American College of Rheumatology (2) and mention a fluid intake volume of more than 2 liters, but they forget about the measure for alkalinizing the urine (Table 3) (2).

In addition to the guidelines, the working group around A. Kanbara also mentions the alkalinization of urine in order to increase the excretion of uric acid as a suitable measure (3).

Remer and Manz classified foods by their potential renal acid load (PRAL) value. In people whose dietary intake consists of at least 70% fruit (not containing too much fructose) or vegetables with clearly negative PRAL values, a pH value of at least 7 adjusts itself in the morning (4). This means that notably less uric acid is readsorbed and much more is excreted. If a value of 7 cannot be achieved by dietary measures, sodium, potassium, and/or magnesium salts of citric or carbonic acid can be ingested. Many food supplements containing these salts are available.

As many patients with hyperuricemia also have arterial hypertension, it should also be mentioned that losartan is the only angiotensin II type 1 receptor antagonist that increases renal excretion of urine.