[Prevention and therapy of disorders of purine metabolism]

To the most important prophylactic measures for the prevention of a disturbance of the purine metabolism belong the normalisation of the body-weight, a mixed diet without protein carriers containing much purine, a regular physical activity, a life without hectic conditions as well as without an excess of conflict situations and a moderate taking of alcohol. These recommendations are of particular importance for patients endangered by gout. In patients with hyperuricaemia they form the basic treatment for the prevention of a uric arthritis, a urate nephrolithiasis and a gouty nephropathy. The clinical and paraclinical results of the directives must be continuously tested with regard to the effectiveness. To the comprehensive prophylaxis also belong the preventive measures against an associated disturbance of an associated disturbance of metabolism or concomitant disease. An additional medicamentous therapy is necessary, when the success of the basic therapy is insufficient and there are already organ manifestations of a disturbance of the purine metabolism. The application of antihyperuraemic drugs corresponding to types should be performed by uricostatic drugs, uricosuric drugs and citric acid-citrate mixtures. The approach according to a 3-step-programme is most useful. In the treatment of the concomitant diseases certain preventive measures are to be taken into consideration. The therapy of an acute attack of gout is at present without any essential problems. Patients with disturbances of the purine metabolism need a permanent care by the physician.