Uricemia (clinical analyzes)

Content

Introduction

Introduction

Uricemia is the measurement of the concentration of uric acid in the blood.

Uric acid is the terminal transformation product (metabolism) of purines, the molecules (nitrogenous bases) that make up nucleic acids (DNA, RNA).

Purines (adenine and guanine) are produced for the most part inside the human body through cell renewal, while a small part comes from certain foods introduced with the diet.

Excess purines are eliminated by the kidneys through the urine and the remainder through the faeces, always in the form of uric acid.

An increase in the concentration of uric acid in the blood (hyperuricaemia) can be caused by its overproduction in the body or by a decreased ability of the kidney to excrete it in the urine.

The cause of the overproduction of uric acid may be due to increased cell death following chemotherapy and radiotherapy or to genetic changes present at birth (congenital) that affect purine metabolism. This is the case with metabolic diseases such as gout, an inflammation that occurs when uric acid-derived crystals form in the fluid found in the joints.

The decreased elimination of uric acid can be caused by persistent (chronic) kidney disease, alcoholism or preeclampsia (gestosis).

Low blood uric acid levels are much less common and are rarely a cause for concern. Although low values ​​may be associated with some liver and kidney diseases (Wilson's disease and Fanconi's syndrome).

The doctor prescribes the "uricaemia test in case of:

  • joint pain or other associated ailments, or caused by gout
  • chemotherapy or radiotherapy, to check uric acid levels
  • kidney stones that are repeated or at risk of formation,
  • pregnant women, to evaluate any preeclampsia
The test

The test

The uricaemia test is performed by simply drawing blood by inserting a needle into a vein in the arm. It does not require special preparation, it is sufficient to fast for at least 8-10 hours.

Results

Results

Normal blood urea levels may vary depending on the reference values ​​adopted by each laboratory. In addition to showing the uricemia value found in the test results, the levels, minimum and maximum, considered normal are also indicated. In adults they are included, for men between 2.5 and 8 milligrams per deciliter (mg / dl), for women between 1.9 and 7.5 milligrams per deciliter (mg / dl).

The guidelines of the American College of Rheumatology have established a risk threshold set at 6mg / dl of blood.

Uric acid can reach high levels in the blood (hyperuricaemia) when the kidneys are unable to eliminate it effectively.

Causes include:

  • foods rich in purines (liver, game meat, anchovies, sardines, gravy, dried beans and peas, mushrooms)
  • obesity
  • diabetes
  • genetic factors (heredity)
  • diuretics
  • hypothyroidism
  • psoriasis
  • niacin or vitamin B3
  • immunosuppressive drugs
  • kidney failure
  • excessive alcohol intake
  • tumor lysis syndrome (a rapid release of cells into the blood caused by certain cancers or following chemotherapy)

Furthermore, recent studies seem to indicate hyperuricemia among the risk factors for metabolic syndromes and cardiovascular diseases.

Uric acid plays an important role in oxidative stress and in bone loss.

The processes of uric acid production lead to the formation of a large amount of oxidizing substances that alter the internal wall of blood vessels (endothelium) making them more susceptible to the appearance of atherosclerosis, while the urate crystals that are deposited on the vessel wall increase the possibility of atherosclerotic plaque formation.

Low levels of uric acid in the blood (hypouricemia) can be caused by:

  • some types of tumors
  • fasting and low intake of animal proteins
  • liver disease (viral hepatitis)
  • kidney disease (nephropathies)
  • kidney problems present at birth (defects in the transport of uric acid, Fanconi syndrome)

It is important to underline that, in any case, the reading and interpretation of the results must be performed by the general practitioner and possibly by a specialist.

Bibliography

Bibliography

Mayo Clinic. High uric acid level (English)

PubMed Health. Gout: Overview (English)

American College of Rheumatology. Gout (English)

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