Uric Acid Tests
Uric Acid Tests
Uric acid tests are tests that are done to measure the levels of uric acid in blood serum or in urine.
The uric acid tests are used to evaluate the blood levels of uric acid for gout and to assess uric acid levels in the urine for kidney stone formation. The urine test is used most often to monitor patients already diagnosed with kidney stones, but it can also be used to detect disorders that affect the body's production of uric acid and to help measure the level of kidney functioning.
Uric acid is a waste product that results from the breakdown of purine, a nucleic acid. (Nucleic acids are the building blocks of DNA.) Uric acid is made in the liver and excreted by the kidneys. If the liver produces too much uric acid or the kidneys excrete too little, the patient will have too much uric acid in the blood. This condition is called hyperuricemia. Supersaturated uric acid in the urine (uricosuria) can crystallize to form kidney stones that may block the tubes that lead from the kidneys to the bladder (the ureters).
Patients scheduled for a blood test for uric acid should be checked for the following medications: loop diuretics (Diamox, Bumex, Edecrin, or Lasix); ethambutol (Myambutol); vincristine (Oncovin); pyrazinamide (Tebrazid); thiazide diuretics (Naturetin, Hydrex, Diuril, Esidrix, HydroDiuril, Aquatensen, Renese, Diurese); aspirin (low doses); acetaminophen (Tylenol); ascorbic acid (vitamin C preparations); levodopa (Larodopa); or phenacetin. These drugs can affect test results.
Certain foods that are high in purine may increase the patient's levels of uric acid. These include kidneys, liver, sweetbreads, sardines, anchovies, and meat extracts.
Patients should be checked for the following medications before the urine test: diuretics, aspirin, pyrazinamide (Tebrazid), phenylbutazone, probenecid (Benemid), and allopurinol (Lopurin). If the patient needs to continue taking these medications, the laboratory should be notified.
The laboratory should also be notified if the patient has had recent x-ray tests requiring contrast dyes. These chemicals increase uric acid levels in urine and decrease them in blood.
The uric acid blood test is performed on a sample of the patient's blood, withdrawn from a vein into a vacuum tube. The procedure, which is called a venipuncture, takes about five minutes. The urine test requires the patient to collect all urine voided over a 24-hour period, with the exception of the very first specimen. The patient keeps the specimen container on ice or in the refrigerator during the collection period.
The uric acid test requires either a blood or urine sample. For the blood sample, the patient should be fasting (nothing to eat or drink) for at least eight hours before the test. The urine test for uric acid requires a 24-hour urine collection. The urine test does not require the patient to fast or cut down on fluids. Some laboratories encourage patients to drink plenty of fluids during the collection period.
Risks for the blood test are minimal, but may include slight bleeding from the puncture site, a small bruise or swelling in the area, or fainting or feeling lightheaded.
Reference values for blood uric acid vary from laboratory to laboratory but are generally found within the following range: Male: 2.1-8.5 mg/dL; female: 2.0-6.6 mg/dL. Values may be slightly higher in the elderly.
Reference values for 24-hour urinary uric acid vary from laboratory to laboratory but are generally found within the following range: 250-750 mg/24 hours.
The critical value for the blood test is a level of uric acid higher than 12 milligrams per deciliter (about 3.4 ounces).
Increased production of uric acid may result from eating foods that are high in purine. Increased uric acid levels due to overproduction may also be caused by gout, by a genetic disorder of purine metabolism, or by metastatic cancer, destruction of red blood cells, leukemia, or cancer chemotherapy.
Decreased excretion of uric acid is seen in chronic kidney disease, low thyroid, toxemia of pregnancy, and alcoholism. Patients with gout excrete less than half the uric acid in their blood as other persons. Only 10-15% of the total cases of hyperuricemia, however, are caused by gout.
Abnormally low uric acid levels may indicate that the patient is taking allopurinol or probenecid for treatment of gout; may be pregnant; or suffers from Wilson's disease or Fanconi's syndrome.
Pagana, Kathleen Deska. Mosby's Manual of Diagnostic and Laboratory Tests. St. Louis: Mosby, Inc., 1998.
Fanconi's syndrome— A rare disorder caused by vitamin D deficiency or exposure to heavy metals.
Gout— A metabolic disorder characterized by sudden recurring attacks of arthritis caused by deposits of crystals that build up in the joints due to abnormally high uric acid blood levels. In gout, uric acid may be overproduced, underexcreted, or both.
Hyperuricemia— Excessively high levels of uric acid in the blood, often producing gout.
Purine— A white crystalline substance that is one of the building blocks of DNA. Uric acid is produced when purine is broken down in the body.
Uric acid— A compound resulting from the body's breakdown of purine. It is normally present in human urine only in small amounts.
Uricosuria— Increased levels of uric acid in the urine.
Wilson's disease— A rare hereditary disease marked by the buildup of copper in the liver and brain, causing loss of kidney function.
uric acid (yŏŏr´Ĭk), white, odorless, tasteless crystalline substance formed as a result of purine degradation in man, other primates, dalmatians, birds, snakes, and lizards. The last three groups of animals also channel all amino acid degradation into the formation of glycine, aspartic acid, and glutamine, which combine to form purines and finally uric acid; these so-called uricotelic organisms thus excrete uric acid as the major end-product of the metabolism of all nitrogen-containing compounds. Uric acid is a very weak organic acid that is barely soluble in water and insoluble in alcohol and ether. The urates are its salts. Uric acid is present in human urine only in extremely small amounts but constitutes a large part of the body waste matter of birds (see guano) and of reptiles. It collects sometimes in the human kidneys or bladder in calculi, or stones, and is responsible, when present in tissues or deposited upon bones in the form of urates, for gouty conditions (see gout). It occurs also in normal human blood. The pure acid is obtained from guano and other similar substances. Upon decomposition urea is obtained. A common test for the presence of the acid in urine depends upon the formation of murexide (an ammonium salt), which is an intense reddish purple. Nitric acid is added to the urine, which is then evaporated. If uric acid is present, murexide is formed when ammonia is added to the residue.
u·ric ac·id / ˈyoŏrik/ • n. Biochem. an almost insoluble compound, C5H4N4O3, which is a breakdown product of nitrogenous metabolism. It is the main excretory product in birds, reptiles, and insects. DERIVATIVES: u·rate / ˈyoŏrˌāt/ n. .