Serum Urate
Contents
Summary
Uric acid is the end product of purine, nucleic acid, and nucleoprotein metabolism. The levels of uric acid are indicative of the end product of protein utilization and deamination in the liver. The amount of uric acid produced and excreted serves as an indirect marker of renal function, the kidneys being responsible for storing and excreting 2/3rds of the uric acid produced daily. The remaining 1/3rd of uric acid is excreted in the stool. An excessive breakdown and catabolism of nucleic acids, increased destruction of cells, and an inability to adequately excrete uric acid can all lead to an over-production of uric acid. [1],[2]
Discussion
- Uric acid levels are conventionally measured for gout, renal failure, and leukemia.
- The levels of uric acid also serve as a strong indicator for potential inflammation and metabolic disturbance.
Patient Preparation
- Some institutions may recommend fasting.
Interfering Factors
- Factors which can cause increased levels: Stress and strenuous exercise, High-protein infusion
- Drugs: alcohol, ascorbic acid, aspirin (low dose), caffeine, cisplatin, diazoxide, epinephrine, ethambutol, levodopa, methyldopa (Aldomet), nicotinic acid, phenothiazines, and theophylline.
- Factors which can cause decreased levels: X-ray contrast agents
- Drugs: allopurinol, aspirin (high dose), azathioprine (Imuran), clofibrate, corticosteroids, estrogens, diuretics, glucose infusions, guaifenesin, mannitol, probenecid, and warfarin
Clinical Implications
Ranges
The following are the reference ranges for this lab. However, lab ranges can vary by laboratory and country. [2]
| Standard U.S. Units | Standard International Units | |
|---|---|---|
| Conventional Laboratory Range | 2.2-7.7 mg/dL | 131-458 umol/L |
| Optimal Range | Males: 3.5-5.9 mg/dL, Females: 3.0-5.5 mg/dL | Males: 208-351 umol/L, Females: 178-327 umol/L |
| Alarm Ranges | < 2.0 or > 9.0 mg/dL | < 119 or > 535 umol/L |
High
- Gout
- Atherosclerosis
- Oxidative Stress and Free Radical Activity
- Rheumatoid Arthritis
- Renal insufficiency
- Renal disease
- Circulatory disorders
- "Leaky Gut" syndrome
- Drug and toxicity causes: Drug diuretics (especially thiazides), Aspirin(even low dose), Theophylline, Caffeine, theobromine (coffee, tea, colas), Heavy metal body burden (or decreased)
- Other conditions: Para-thyroid hyperfunction, Liver/Biliary dysfunction, Thyroid hypofunction, "Stress", increase in dietary purines, Diabetes, congestive heart failure, Neoplasm, Polycythemia, Inflammatory conditions (arthralgias etc.), Acidosis, Fasting, Lead poisoning
Low
- Molybdenum Deficiency
- Anemia- B12/Folate Deficiency
- Copper Deficiency
- Pregnancy
- Drug and toxicity causes: Aspirin (high doses), Corticosteroids, Heavy metal poisoning
- Other conditions: Wilson's disease, Familial periodic paralysis, Improper RBC production, Obstructive Liver Disease, Neoplasm, Fanconi's syndrome
Associated Tests
- Serum creatinine, BUN, Blood electrolytes, ALT, AST, GGTP, serum ALP, ALP isoenzymes, MCV, MCH, RBC HCT, HGB, ESR, Basophils, gamma Globulin, Rheumatoid factor, Phosphorus, heavy metal screening, Homocysteine, C reactive protein
References
- ↑ Pagana Kathleen D., Pagana Timothy J., Mosby's Manual of Diagnostic and Laboratory Tests, Mosby, Inc
- ↑ 2.0 2.1 Weatherby Dicken, Ferguson Scott. Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Functional Perspective, Bear Mountain Cite error: Invalid
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