Know your test: Uric Acid

Uric acid is a natural substance produced in our body which has both good and bad side effects. Under normal concentrations, it is a very potent antioxidant which accounts for more than 50 percent of the antioxidant activity in our blood. When its levels are normal, it is beneficial. But when it is high, it precipitates into crystals and can be harmful. In its crystal form, uric acid causes a lot of swelling or inflammation in the various tissues of the body.
Uric acid is produced by the breakdown of purines. Purines are nitrogen-containing compounds found in the cells of the body, including our DNA. As cells get old and die, they break down, releasing purines into the blood.To a lesser extent, purines may come from the digestion of certain foods. Most uric acid is removed from the body by the kidneys and is excreted in the urine, with the remainder eliminated in the stool. The uric acid test measures the level of uric acid in the blood or urine.
If too much uric acid is produced or not enough is excreted, it can accumulate in the body, causing increased levels in the blood (hyperuricemia). The presence of excess uric acid can cause gout, a condition characterised by inflammation of the joints accompanied by mild to excruciating pain due to the formation of uric acid crystals in the joint (synovial) fluid. Excess uric acid can also be deposited in the tissues such as the kidneys, leading to the formation of kidney stones or kidney problems.
The accumulation of too much uric acid is due to increased production, decreased elimination, or a combination of both. Elevated uric acid levels can occur when there is an increase in cell death, as seen with some cancer therapies or, rarely, as an inherited tendency to overproduce uric acid. Decreased elimination of uric acid is often the result of impaired kidney function due to kidney disease.
WHAT IS IT USED FOR?
A uric acid test if often used to:
Help diagnose gout
Help find the cause of frequent kidney stones
Monitor uric acid level for people undergoing certain cancer treatments. Chemotherapy and radiotherapy can cause high levels of uric acid to go into the blood.
WHEN TO GET TESTED?
Uric acid test is done when one has symptoms of gout. These include:
Pain and/or swelling in the joints, especially in the big toe, ankle or knee.
Reddish, shiny skin around the joints.
Joints that feel warn when touched.
Uric acid test is also performed when one has symptoms of kidney stones. These include:
Sharp pains in the abdomen, side or groin
Back pain
Blood in the urine
Pain when urinating
Frequent urge to urinate
Cloudy or bad-smelling urine
Nausea and vomiting
In addition, the test may be done in patients undergoing radiotherapy/chemotherapy for cancer.
WHAT HAPPENS DURING A URIC ACID TEST?
A uric acid test can be done either as a blood test or a urine test.
During a blood test, a healthcare professional will take a blood sample from the vein in your arm, using a small needle. The procedure usually takes less than five minutes.
For a uric acid urine test, you will need to collect all urine passed in a 24-hour period. This is called a 24-hour urine uric acid test.
PREPARATION FOR THE TEST
No preparation is needed. However, it is advisable to discuss with the doctor about any medications being taken before having the test.
WHAT DO THE RESULTS MEAN?
If your blood test shows high level of uric acid, it could mean you have:
Kidney disease
Preeclampsia, a condition that can cause dangerously high blood pressure in pregnant women
A diet that includes too many purine-rich foods
Alcoholism
Side effect from cancer treatment
Low levels of uric acid in the blood are uncommon and usually not a cause for concern.
If your urine uric acid test results show high levels of uric acid, it may mean you have:
Gout
A diet that includes too many purine-rich foods
Leukaemia
Multiple myeloma
Side effect from cancer treatment
Obesity
Low levels of uric acid in urine may be sign of kidney disease, lead poisoning, or heavy alcohol use.
IS THERE ANYTHING ELSE TO KNOW?
Some people with high uric acid levels do not have gout or other kidney disorders. You may not treatment if you do not have any symptoms of disease. Be sure to talk to your healthcare provider if you are concerned about your uric acid levels, and/or if you start to have any symptoms.
(The writer is Junior Consultant Pathologist, BABINA Diagnostics, Imphal)