Uric acid is a waste product formed from the breakdown of purines—compounds found in certain foods and cells. It is usually dissolved in blood, filtered through the kidneys, and excreted in urine. However, when levels become elevated, a condition known as hyperuricemia arises, increasing the risk of gout and kidney stones.
📌 What Is Uric Acid?
- Final product of purine metabolism
- Produced mainly in the liver
- Excreted via kidneys (~70%) and intestines (~30%)
🧪 Reference Ranges
| Group | Uric Acid (mg/dL) |
|---|---|
| Adult Male | 3.5 – 7.0 |
| Adult Female | 2.5 – 6.0 |
| Children | 2.0 – 5.5 |
⚠️ Causes of Hyperuricemia
1. Increased Production
- High-purine diet (organ meats, red meat, seafood)
- Alcohol consumption (especially beer)
- Genetic disorders (e.g., Lesch-Nyhan syndrome)
- Malignancies or rapid cell turnover (chemotherapy, psoriasis)
2. Decreased Excretion
- Chronic kidney disease
- Diuretics (thiazides, loop diuretics)
- Lead nephropathy
- Dehydration
🧬 Uric Acid and Gout
Gout is a form of inflammatory arthritis caused by deposition of monosodium urate crystals in joints, tendons, and soft tissues.
- Sudden, severe joint pain—commonly the big toe (podagra)
- Warm, red, swollen joints
- Tophi formation in chronic cases
Diagnosis: Confirmed by joint aspiration and identification of needle-shaped negatively birefringent urate crystals under polarized microscopy.
💎 Uric Acid and Kidney Stones
- High uric acid → acidification of urine → uric acid stones
- Seen in 10–15% of kidney stone patients
- Crystals appear as rhomboid or rosette shapes in urine microscopy
🧾 Diagnostic Approach
- Serum uric acid: Initial screening test
- 24-hour urine uric acid: To differentiate under-excretors from over-producers
- Urine pH: Helps detect risk of uric acid stones (acidic pH favors stone formation)
💊 Management of Hyperuricemia
Lifestyle Modifications
- Limit red meat, seafood, sugary beverages, alcohol
- Weight loss in obese individuals
- Hydration: Maintain good urine output
Medications
- Allopurinol, Febuxostat: Xanthine oxidase inhibitors (↓ uric acid production)
- Probenecid: Uricosuric agent (↑ excretion)
- Colchicine, NSAIDs: For acute gout attacks
🔗 Related Articles
- Kidney Function Tests: Urea, Creatinine, eGFR
- Arthritis Lab Markers: CRP, ESR, RF, and ANA
- Understanding Metabolic Syndrome and Lab Markers
❓ Frequently Asked Questions
1. Does high uric acid always mean gout?
No. Many people with hyperuricemia never develop gout, and gout can occasionally occur with normal uric acid levels.
2. Can uric acid be lowered naturally?
Yes. Dietary control, reducing alcohol intake, weight management, and staying well-hydrated can help reduce levels naturally.
3. Is uric acid checked in urine too?
Yes, a 24-hour urine test helps identify whether high levels are due to overproduction or under-excretion.
✅ Conclusion
Uric acid is more than just a number—its elevation can signal metabolic imbalance, renal dysfunction, or inflammatory conditions like gout. A proper understanding of its sources, significance, and clinical consequences is vital for accurate diagnosis and management.
Tags: Uric Acid, Gout, Hyperuricemia, Kidney Stones, Lab Tests, Rheumatology, Urology, Clinical Biochemistry
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