Uric Acid — Normal Range & Interpretation

Clinical Context

Uric acid is the end product of purine metabolism, filtered by the kidneys and excreted in urine. Serum levels reflect the balance between purine breakdown, renal clearance, and cellular turnover. Clinicians order this test to evaluate joint pain suspicious for gout, monitor patients on urate-lowering therapy, and assess risk during cytotoxic chemotherapy.

Elevations point to gout, chronic kidney disease, tumor lysis syndrome, psoriasis, and high-purine diets rich in red meat, organ meats, and shellfish. Thiazide and loop diuretics raise levels, as do alcohol and fructose-sweetened beverages. Depressed values occur with allopurinol or febuxostat therapy, SIADH, Fanconi syndrome, and severe liver disease that impairs purine synthesis.

Classic AANP vignette: hyperuricemia in the textbook gout presentation — an older adult man with sudden podagra, warmth, and erythema of the first metatarsophalangeal joint. Expect questions linking thiazide initiation in a hypertensive patient to a subsequent gout flare, and questions distinguishing acute flare management with NSAIDs or colchicine from chronic urate-lowering therapy with allopurinol. Know that uric acid levels drop during acute attacks, so a normal value does not exclude gout when clinical suspicion is high. Recognize tumor lysis syndrome as a medical emergency presenting with hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia.

Related Labs

• HbA1c — %
• ESR — mm/hr
• CRP — mg/dL
• hs-CRP — mg/L
• Iron (serum) — μg/dL

Sources

• MedlinePlus