What are the Symptoms of Gout - Uric Acid Testing
DefinitionUric acid tests are tests that are done to measure the levels of uric acid in blood serum or in urine.
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.
PreparationThe 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.
Urine testReference 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 Uric Acid Tests are Used to Evaluate the Blood LevelsOf 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.
Blood testPatients 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.
Key Terms<dl> <dl> <dt>Fanconi's syndrome</dt> <dd>A rare disorder caused by vitamin D deficiency or exposure to heavy metals. </dd> <dt>Gout</dt> <dd>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. </dd> <dt>Hyperuricemia</dt> <dd>Excessively high levels of uric acid in the blood, often producing gout. </dd> <dt>Purine</dt> <dd>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. </dd> <dt>Uric acid</dt> <dd>A compound resulting from the body's breakdown of purine. It is normally present in human urine only in small amounts. </dd> <dt>Uricosuria</dt> <dd>Increased levels of uric acid in the urine. </dd> <dt>Wilson's disease</dt> <dd>A rare hereditary disease marked by the buildup of copper in the liver and brain, causing loss of kidney function.</dd> </dl> </dl>
For Your Information
- Laboratory Test Handbook, edited by David S. Jacobs. Cleveland, OH: Lexi-Comp Inc., 1996.
- Mosby's Diagnostic and Laboratory Test Reference, edited by Kathleen Deska Pagana and Timothy James Pagana. St. Louis: Mosby-Year Book, Inc., 1998.
- Springhouse Corporation. Handbook of Diagnostic Tests, edited by Matthew Cahill. Springhouse, PA: Springhouse Corporation, 1995.
- 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.
Uric Acid is a Waste Product that Results from theBreakdown 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).
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Abnormal resultsThe critical value for the blood test is a level of uric acid higher than 12 milligrams per deciliter (about 4 ounces). .
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RisksRisks 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.
Blood testReference 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.
- 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.
DescriptionThe 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. Did you ever believe that there was so much to learn about Kidney Stones? Neither did we! Once we got to write this article, it seemed to be endless.
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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.
- 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.