URIC ACID TEST
Also known as a serum uric acid measurement, a uric acid blood test determines how much uric acid is present in a person’s blood. The test can help determine how well the body produces and removes uric acid.
Uric acid is a chemical that is produced when foods that contain organic compounds called purines is broken down by the body, also as cells get old and die, they break down, releasing purines into the blood.
Foods and beverages with high purine content include:
- Liver
- Anchovies
- Mackerel
- Dried beans
- Beer
- Wine
Most of uric acid is dissolved in the blood, filtered through the kidneys, and is expelled in the urine. There are times that the body produces too much uric acid or does not filter out enough of it. When one has too much uric acid in his/her body, the disorder that occurs is called Hyperuricemia.
High levels of uric acid is the cause of a condition called gout. Gout is a form of arthritis that causes swelling of especially the feet and big toes. Hyperuricemia also causes increased cell death, due to cancer or cancer treatments or, rarely as an inherited tendency to produce too much uric acid. This can lead to an accumulation of uric acid in the body. Excess uric acid can also be deposited in tissues such as the kidney, leading to kidney stones or kidney failure
There is also the possibility of having too little uric acid in one’s blood, this is a symptom of liver or kidney disease. It also is a symptom of Fanconi syndrome, a disorder of the kidney tubules that prevents the absorption of substances such as glucose and uric acid. These substances are then passed in the urine instead.
PURPOSES OF A URIC ACID BLOOD TEST
The test is used most commonly to:
- Diagnose and monitor people with gout
- Diagnose kidney disorders
- Find the cause of kidney stones
- Monitor people who are undergoing chemotherapy or radiation treatment
- Check kidney function after an injury
One may need a uric acid test if:
- He/she has joint pain or swelling that may be related to gout
- He/she has been diagnosed with gout in the past
- He/she has frequent kidney stones
- He/she is currently undergoing chemotherapy
- He/she is about to begin chemotherapy
Another option for uric acid testing is to test the urine over a 24-hour period. Sometimes the doctor will recommend both to confirm a diagnosis.
PREPARING FOR A URIC ACID BLOOD TEST
The following may interfere with the uric acid test results:
- Alcohol
- Some medications, such as ibuprofen (Motrin IB) and aspirin
- High levels of vitamin C
- Dyes that are used in X-ray tests
The doctor must know about any prescription or over-the-counter medications or supplements the patient is taking.
You may need to refrain from eating or drinking (fast) for four hours before the test.
HOW SAMPLES ARE COLLECTED
A blood sample is obtained by inserting a needle into a vein in the arm. A 24-hour urine sample may be collected for the urine uric acid test. A collection container is obtained from the doctor or the laboratory and follow the directions that will be given for the collection of samples. To preserve the substance to be tested, the container may need to be refrigerated during the entire collection process.
Upon waking up in the first morning, the patient’s bladder must be emptied normally into the toilet and discard that urine. Note the time.
For the next 24 hours, all urine must be saved in the container provided. When the 24 hours are over, the bladder is emptied and this urine is added to the container. Note the time.
Bring all of the urine collected to the lab or the doctor's office.
A 24-hour urine sample may be preferred to a random urine sample because amounts of various substances in the urine changes during the course of a day. By collecting all urine for 24 hours, the amount of the substance being measured in the urine can be averaged over the entire day. This will give a better indication of what is going on in the body.
HOW A URIC ACID BLOOD TEST IS DONE
The process of obtaining a blood sample for testing is called venipuncture.
The doctor or another healthcare provider takes blood from a patient’s vein, usually from the inner elbow or the back of one’s hand. First, the area is sterilized with an antiseptic. Then an elastic band is wrapped around the arm to allow blood to fill the veins.
Next, a needle is inserted into the vein. The blood is collected in an attached vial. Once the blood has been collected, the plastic band is untied and the needle removed from the vein. Pressure is applied to the site of the needle’s entry and if necessary, a bandage is applied.
For infants and young children, a small cut may be made on the arm and a test strip or slide used to collect a small sample of blood. The area is then cleaned and bandaged if necessary.
The blood that is collected is sent to a laboratory for analysis.
ANALYSING THE TEST RESULTS
Based on gender, Uric acid levels may vary. Normal values for women are 2.5 to 7.5 milligrams/deciliter (mg/dL) and for men 4.0 to 8.5 mg/dL. However, the values may also vary according to the lab that does the testing. The target level if you have gout is a blood uric acid level of less than 6.0 mg/dL. Low levels of uric acid are less common than high levels and are less of a health concern.
High levels of uric acid in the blood typically indicates that either the body is making too much uric acid or that the kidneys aren’t removing enough of it from the body. Having cancer or undergoing cancer treatment can also raise uric acid levels.
High uric acid levels in the blood can also be indicative of a variety of conditions, including:
- Gout, which involves recurring attacks of acute arthritis
- Chemotherapy
- Bone marrow disorders, such as leukemia
- A diet high in purines
- Diabetes
- Cancer of the plasma cells in the bone marrow (multiple myeloma)
- Cancer that has spread from its original site (metastasized cancer)
- A decrease in the parathyroid function (hyperparathyroidism)
- Kidney disorders, e.g. acute kidney failure
- Kidney stones
It may be worthy to note that the blood uric acid test is not considered as a definitive test for gout. It is only the testing of a person’s joint fluid for monosodium Urate that can absolutely confirm the presence of gout. However, the doctor can make a calculated guess based on factors like high blood levels and gout symptoms.
There remains the possibility of asymptomatic Hyperuricemia, i.e. to have high uric acid levels without the symptoms of gout.
Low levels of uric acid in the blood may suggest:
- An inherited disorder that causes copper to build up in body tissues (Wilson’s disease)
- Fanconi syndrome, a kidney disorder most commonly caused by cystinosis
- A diet low in purines
- Liver or kidney disease
- Alcoholism
After the uric acid test
Results of the uric acid blood test can help determine the appropriate treatments. In some cases, one may not need any treatment.
If gout is diagnosed, the treatment could include
- Taking medications to reduce pain and swelling.
- Changes in diet to cut back on purines. Change of diet can also be beneficial if patient has chronic uric acid kidney stones.
- Frequent blood test to monitor uric acid levels to it does not become too high especially if the patient is undergoing different chemotherapy treatments, you may need.
