Hyperuricemia and Kidney Disease

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Urine is liquid waste. It consists of water, salt, and the chemicals urea and uric acid.

Most uric acid is produced naturally in your body. The rest is converted from substances in certain foods. These substances are called purines. Uric acid levels that are too high may cause hyperuricemia. This is a risk factor for gout and kidney disease.

This article looks at hyperuricemia, its causes, and symptoms. It also discusses possible treatment.

Serum Urate Levels

Most uric acid dissolves in the blood. From there, it travels to the kidneys to be excreted in urine. 

A serum uric acid blood test measures the amount of uric acid in your blood. A normal serum urate level for females is 1.5 to 6.0 mg/dL. For males, it is 2.5 to 7.0 mg/dL.

Hyperuricemia occurs when you produce too much uric acid or are unable to eliminate enough of it. This condition is associated with elevated serum urate, also called uric acid level.

Your uric acid level can also be checked with 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.

Recap

A serum uric acid blood test measures how much uric acid is in your blood. Ideally, your levels should be 6.0 mg/dl or lower.

Causes and Risk Factors for Hyperuricemia 

The primary risk factors for developing hyperuricemia include:

  • Getting older
  • Being male

Studies in the U.S. and New Zealand found that people of African, Maori, or Filipino ancestry are at higher risk than people of European ancestry. Other risk factors include:

Recap

The primary risk factors for hyperuricemia include getting older and being male. Certain medical conditions may also put you at risk.

Symptoms and Complications of Hyperuricemia 

Hyperuricemia itself is not a disease. In some cases, it does not cause symptoms or problems. Still, long-term hyperuricemia may lead to the development of uric acid crystals. These can be problematic.

High uric acid levels can result in gout or kidney disease. These are the two most common conditions related to hyperuricemia.

With gout, uric acid crystals build up in the joints. This causes inflammation and the breakdown of joint cartilage. Symptoms include:

  • Pain
  • Swelling
  • Redness
  • Stiffness
  • Deformity
  • Inflammation
  • Limited range of motion
Stages of Gout

Verywell / Emily Roberts

Uric acid crystals can also be deposited in the kidneys. This causes kidney stones which can be very painful. If left untreated, they can block the urinary tract and cause infections. Symptoms of kidney stones include:

  • Pain or aching in your lower back, side, abdomen, or groin
  • Nausea
  • Increased urge to urinate
  • Pain when urinating
  • Difficulty urinating
  • Blood in your urine
  • Foul-smelling or cloudy urine

Kidney stones can also cause urinary tract infections (UTIs). This is because they harbor bacteria. Symptoms of a UTI are similar to those of kidney stones. There may also be fever or chills.

Over time, kidney stones and other forms of kidney damage can lead to chronic kidney disease. This makes it more difficult to get rid of uric acid.

Untreated kidney disease can lead to kidney failure or loss of kidney function.

Recap

Hyperuricemia can cause gout or kidney stones. Chronic kidney stones can eventually lead to kidney disease.

Treatment of Hyperuricemia 

If you don't have symptoms, you don't necessarily need treatment. When symptoms are present, a change in diet may help. Eating foods low in some non-plant-based purines may help regulate uric acid levels.

Increased Uric Acid
  • Organ meats, meat extracts, and gravy

  • Sardines, anchovies, shellfish, and tuna

  • Beer and other alcoholic beverages

  • Sugary foods and beverages, such as soda, that contain high-fructose corn syrup

Decreased Uric Acid
  • Milk and milk products

  • Eggs

  • Lettuce, tomatoes, and green vegetables

  • Cream soups without meat stock

  • Peanut butter and nuts

  • Citrus fruits

Drink plenty of water each day. This will help the kidneys flush out uric acid. Some studies suggest drinking coffee on a regular basis can help prevent gout. If dietary changes don't control your hyperuricemia, your doctor may prescribe medications.

Urate-lowering therapies are the preferred medication for most patients with gout. Options include:

  • Benemid (probenecid): This is a uricosuric medication. This drug increases excretion of uric acid in the urine.
  • Zyloprin (allopurinol), Uloric (febuxostat): These drugs are called xanthine oxidase inhibitors. (XOIs). They reduce the body’s production of uric acid.
  • Zurampic (lenisurad): This is prescribed with an XOI to increase its effects.
  • Krystexxa (pegloticase): Pegloticase is given by intravenous infusion. It changes uric acid into a substance called allantoin. Your body can easily eliminate allantoin. This drug is reserved for people who have not had success with other gout medications.

Recap

You may be able to reduce your uric acid levels with a change in diet. Drinking lots of water can also help your kidneys flush out uric acid. If these things don't help, your doctor may prescribe medication.

Summary

Hyperuricemia occurs when you produce too much uric acid or can't eliminate enough of it. Getting older and being male are the two major risk factors for this condition.

Hyperuricemia can lead to gout, when uric acid crystals build up in the joints. It can also cause uric acid crystals to form in the kidneys. Over time, this may lead to kidney disease.

A diet low in purines may help control uric acid levels. Foods that are low in purines include milk, eggs, nuts, and citrus fruits.

If you can't control your hyperuricemia with diet, your doctor may prescribe medication. 

A Word From Verywell

Knowing your uric acid level is just as important as knowing your cholesterol and blood glucose levels.

Talk to your doctor if you have sore joints or frequent urinary tract infections. If you've had attacks of gout, you should have your uric acid levels tested. You'll need to test every six months to ensure that your levels stay under 6.0 mg/dl.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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