Uric Acid Levels and Disease

Urine and blood samples
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When cells break down in the body, organic compounds called purines are released. These compounds exist naturally in the body as well as in many foods, including anchovies, dried beans, beer, and wine. Purines serve as a form of energy for cells and are necessary for the production of DNA and RNA, proteins, starch, regulation of enzymes, and cell signaling. However, having elevated levels of uric acid—a condition known as hyperuricemia— is unhealthy, potentially causing gout and kidney disease.

Serum Urate Levels

Most uric acid dissolves in the blood, then travels to the kidneys to be excreted in urine. Normally, people maintain a stable serum urate level between 4 and 6.8 mg/dl, as well as a total body uric acid count of 1000 mg. If you produce too much uric acid, or are unable to eliminate enough of it, you may have elevated serum urate levels, which can lead to hyperuricemia; this, in turn, can result in gout and/or kidney disease.

A blood test is one way to check your uric acid level; it can also be checked using a urine sample. Ideally, your serum uric acid level should be 6.0 mg/dl or lower. A uric acid level of 6.8 mg/dl or higher indicates hyperuricemia.

Gout and Kidney Disease

While hyperuricemia itself is not a disease, and in some cases causes no problems, a prolonged state of hyperuricemia may lead to the development of crystals. The two most common conditions that can result from high uric acid levels are gout and kidney disease. With gout, uric acid crystals build up in the joints, provoking inflammation and the breakdown of joint cartilage. Symptoms include pain, swelling, stiffness, deformity, and limited range of motion.

Uric acid crystals can also be deposited in the kidneys, causing kidney stones to form. These can be very painful and, if left untreated, can block the urinary tract and result in infection. Research has shown that one in five people with gout will develop kidney stones.

Over time, kidney stones and damage can lead to chronic kidney disease, which makes it more difficult to get rid of uric acid. Untreated kidney disease can ultimately lead to kidney failure, or loss of kidney function.

Causes and Risk Factors

Risk factors for hyperuricemia include:

  • Metabolic syndrome—a disorder that involves obesity, abnormal blood pressure, dysglycemia (blood sugar disorders), dyslipidemia (lipid disorders)
  • A diet that is high in purines, protein, alcohol, and carbohydrates
  • Medications, including thiazides, loop diuretics, and low dose aspirin
  • Acidosis
  • Chemotherapy
  • Diabetes
  • Hypoparathyroidism
  • Lead poisoning
  • Polycythemia vera
  • Toxemia related to pregnancy

Treatment

In some cases, a diet low in purines can help regulate uric acid levels. If that is not effective, your doctor may prescribe a medication to control your levels.

Foods that are high in purine include:

  • Organ meats, meat extracts, and gravy
  • Beer and other alcoholic beverages
  • Asparagus, spinach, beans, peas, lentils, oatmeal, cauliflower, and mushrooms

Foods that are low in purine include:

  • Refined cereals - breads, pasta, flour, tapioca, and cakes
  • Milk and milk products, eggs
  • Lettuce, tomatoes, and green vegetables
  • Cream soups without meat stock
  • Water, fruit juice, and carbonated drinks
  • Peanut butter, fruits, and nuts

Avoid caffeine, as it can also contribute to problems with uric acid and hyperuricemia.

Prescription medications that are used to control uric acid levels include:

  • Benemid (probenecid)
  • Uloric (febuxostat)
  • Zyloprin (allopurinol)

A Word From Verywell

It is important to know your uric acid level, just as it is important to know your cholesterol or blood glucose levels. Talk to your doctor if you are experiencing sore joints or frequent urinary tract infections. If you've had attacks of gout, you should have a uric acid level performed every six months to ensure that it remains under 6.0 mg/dl.

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