Type of test Blood, urine

 Normal findings

 Blood

 Adult Male: 4-8.5 mg/dL or 0.24-0.51 mmol/L

Female: 2.7-7.3 mg/dL or 0.16-0.43 mmol/L

Elderly: values may be slightly increased

 Child: 2.5-5.5 mg/dL or 0.12-0.32 mmol/L

Newborn: 2-6.2 mg/dL

Physiologic saturation threshold: > 6 mg/dL or > 0.357 mmol/L

Therapeutic target for gout: < 6 mg/dL or < 0.357 mmol/L

Urine

 250-750 mg/24 hr or 1.48-4.43 mmol/day (SI units)

Possible critical values

 Blood: > 12 mg/dL

 Test explanation and related physiology

 Uric acid is a nitrogenous compound that is a product of purine (a DNA building block) catabolism. Uric acid is excreted to a large degree by the kidney and to a smaller degree by the intestinal tract. When uric acid levels are elevated (hyperuricemia), the patient may have gout. Gout is a common metabolic disorder characterized by chronic hyperuricemia. At high levels, uric acid concentrations exceed the physiologic saturation threshold, and monosodium urate crystals may be deposited in the joints and soft tissues.

Causes of hyperuricemia can be overproduction or decreased excretion of uric acid (e.g., kidney failure). Overproduction of uric acid may occur in patients with a catabolic enzyme deficiency that stimulates purine metabolism or in patients with cancer in whom purine and DNA turnover is great. Other causes of hyperuricemia may include alcoholism, leukemia, metastatic cancer, multiple myeloma, hyperlipoproteinemia, diabetes mellitus, renal failure, stress, lead poisoning, and dehydration caused by diuretic therapy. Ketoacids (as occur in diabetic or alcoholic ketoacidosis) may compete with uric acid for tubular excretion and may cause decreased uric acid excretion. Many causes of hyperuricemia are undefined and therefore labeled as idiopathic.

Elevated uric acid in the urine is called uricosuria. Uric acid can become supersaturated in the urine and crystallize to form kidney stones that can block the renal system. Urinary excretion of uric acid depends on uric acid levels in the blood, along with glomerular filtration and tubular secretion of uric acid into the urine. Uric acid is less well saturated in alkaline urine. As the urine pH rises, more uric acid can exist without crystallization and stone formation. Therefore when a person is known to have high uric acid in the urine, the urine can be alkalinized by ingestion of a strong base to prevent stone formation.

Interfering factors

 • Stress may cause increased uric acid levels.

 • Recent use of x-ray contrast agents may cause decreased serum levels.

• Recent use of x-ray contrast agents may increase uric acid levels in the urine.

* Drugs that may cause increased serum levels include alcohol, ascorbic acid, aspirin (low dose), caffeine, cisplatin, diazoxide, diuretics, epinephrine, ethambutol, levodopa, methyldopa, nicotinic acid, phenothiazines, and theophylline.

* Drugs that may cause decreased serum levels include allopurinol, aspirin (high dose), azathioprine, clofibrate, corticosteroids, estrogens, glucose infusions, guaifenesin, mannitol, probenecid, and warfarin.

* Drugs that may cause increased urine levels include ascorbic acid, calcitonin, citrate, dicumarol, estrogens, glyceryl, iodinated dyes, phenolsulfonphthalein, probenecid, salicylates, steroids, and outdated tetracycline.

 Procedure and patient care

 Before

* Explain the procedure to the patient.

 • Follow the institution’s requirements regarding fasting.

During

 Blood

• Collect a venous blood sample in a red-top tube. Urine Instruct the patient to begin the 24-hour urine collection after voiding. Discard the initial specimen and start the 24-hour timing at that point.

• See inside front cover for Routine Urine Testing.

After

 Blood

• Apply pressure to the venipuncture site.

 Urine

• Transport the urine specimen promptly to the laboratory.

 Abnormal findings

 Increased blood levels (hyperuricemia)

- Gout

- Increased ingestion of purines

- Genetic inborn error in purine metabolism

- Metastatic cancer

- Multiple myeloma

- Leukemia

- Cancer chemotherapy

- Hemolysis

- Rhabdomyolysis (e.g., heavy exercise, burns, crush injury, epileptic seizure, or myocardial infarction)

- Chronic renal disease

- Acidosis (ketotic or lactic)

- Hypothyroidism

- Toxemia of pregnancy

- Hyperlipoproteinemia

- Alcoholism

- Shock or chronic blood volume depletion states

- Idiopathic

Decreased blood levels

- Wilson disease

- Fanconi syndrome

- Lead poisoning

- Yellow atrophy of the liver

Increased urine levels

- Gout

- Metastatic cancer

- Multiple myeloma

- Leukemia

- Cancer chemotherapy

- High purine diet

- Lead toxicity

Decreased urine levels

- Kidney disease

- Eclampsia

- Chronic alcohol ingestion

- Acidosis (ketotic or lactic)

اخر الاخبار

اخبار العتبة العباسية المقدسة

قسم الشؤون الفكرية يصدر كتاب (دروس تمهيدية في الفقه – العبادات)

قسم الشؤون الطبية يشرع بتقديم لقاح الانفلونزا للمنتسبين

المجمع العلمي يختتم مسابقة العميد لحفظ القرآن الكريم في بغداد

لجنة البرامج المركزية تختتم فعاليات البرنامج المركزي الأسبوعي لمنتسبي العتبة العباسية المقدسة

المزيد

الآخبار الصحية

عناصر منزلية قد تؤثر على الخصوبة وفرص الحمل

شكل الدماغ قد يتنبأ بخطر الخرف قبل سنوات

طريقة صينية بسيطة للوقاية من السكري

هل تساعد المانغو في الوقاية من السكري؟

المزيد

الآخبار التكنلوجية

رقم غامض ولا إنترنت.. متوجون بنوبل للطب لم يعلموا بفوزهم

"سيري" تحت المجهر.. تحقيق فرنسي جديد ضد شركة "آبل"

أميركيان وياباني يفوزون بجائزة نوبل للطب

تحول غير مسبوق.. إنستغرام تمنح مفاتيحها للمستخدمين

المزيد

مواضيع ذات صلة

white blood cell scan (WBC scan, Inflammatory scan)

white blood cell count and differential count (WBC and differential, Leukocyte count)

vitamin D (25-hydroxy vitamin D2 and D3 ; 1,25-dihydroxyvitamin D [1,25(OH)2 D])

Basal Hormone Measurements of Testis

vitamin B12 (Cyanocobalamin and methylmalonic acid [MMA])

virus testing

viral cultures

Laboratory Investigations of Pheochromocytoma and Paraganglioma

varicella virus testing (Antibody testing for Varicella zoster virus, Varicella zoster virus [VZV], Herpes virus-3)

uroporphyrinogen-1-synthase

urine culture and sensitivity (C&S)

urea breath test (UBT, Helicobacter pylori breath test)