Uric Acid
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Uric acid is produced mainly in the liver. It is a nitrogenous compound that is the final product in the breakdown of purine. Although most uric acid is derived from the metabolism of endogenous purine, eating foods rich in purines contributes to the total pool of uric acid.[1] Seventy-five percent of uric acid is excreted through the kidneys, and twenty-five is excreted through the intestinal tract. The excretion of uric acid depends on the uric acid levels in the blood, combined with glomerular filtration and tubular secretion of uric acid into the urine. Elevated levels of uric acid can cause nephrolithiasis and ureterolithiasis.[2], [3]
Discussion
- Uric acid levels can be measured in both blood and urine.
- Although most uric acid is derived from the metabolism of endogenous purine, eating foods rich in purines contributes to the total pool of uric acid.[1]
Patient Preparation
- No special diet is required.
- Factors which can cause increased levels:
- Recent use of radiographic contrast agents
- Factors which can cause decreased levels:
Clinical Implications
- There is a strong association of the insulin resistance syndrome (IRS) (abdominal obesity, dyslipidaemia, hypertension, raised serum insulin levels and glucose intolerance) with hyperuricaemia.[1]
- Obesity is associated with both increased production and decreased renal excretion of urate.[1]
Ranges: The following are the reference ranges for this lab. However, lab ranges can vary by laboratory and country. [3]
Standard U.S. Units (mg/dL) | Standard International Units (umol/L) | |
---|---|---|
Conventional Laboratory Range | 2.2 - 7.7 | 131 - 458 |
Optimal Range | Males: 3.5 - 5.9 / Females: 3.0 - 5.5 | Males: 208 - 351 / Females: 178 - 327 |
Alarm Ranges | < 2.0 or > 9.0 | < 119 or > 535 |
High levels indicate:
- Gout
- Atherosclerosis
- Oxidative Stress
- Arthralgias
- Kidney Stones
- Cardiovascular Conditions
- High purine diet
- Metastatic cancer
- Multiple myeloma
- Leukemias
- Cancer chemotherapy
- Uricosuric drugs
- Lead toxicity
Low levels indicate:
- Kidney disease
- Eclampsia
- Chronic alcohol ingestion
- Acidosis
- Copper deficiency
- Molybdenum deficiency
- Anemia - Vitamin B12 / folate deficiency
Associated Tests
References
- ↑ 1.0 1.1 1.2 1.3 Schlesinger N (2005) Dietary factors and hyperuricaemia. Curr Pharm Des;Vol.11(32):4133-8.
- ↑ Pagana Kathleen D, Pagana Timothy J (2006) Mosby's Manual of Diagnostic and Laboratory Tests, Mosby.
- ↑ 3.0 3.1 Weatherby Dicken, Ferguson Scott (2002) Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Functional Perspective, Bear Mountain