At a Glance
Why Get Tested?
To detect high levels of uric acid in the blood, which could be a sign of the condition gout, or to monitor uric acid levels when undergoing chemotherapy or radiation treatment; to detect high levels of uric acid in the urine in order to diagnose the cause of kidney stones and to monitor those with gout who are at risk of developing such stones
When to Get Tested?
When you have joint pain or other symptoms that your doctor suspects may be due to gout; when you have had or are going to have certain chemotherapy or radiation therapies for cancer; when you have recurrent kidney stones; when you have gout or are otherwise at risk for kidney stone formation
A blood sample drawn from a vein in the arm or a 24-hour urine sample
Test Preparation Needed?
None may be needed; however, some institutions recommend fasting. Follow any instructions you are given.
The Test Sample
What is being tested?
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, such as liver, anchovies, mackerel, dried beans and peas and certain alcoholic drinks, primarily beer. Most uric acid is removed from the body by the kidneys and is excreted in the urine, with the remainder eliminated in the stool. This 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 characterized by inflammation of the joints due to the formation of uric acid crystals in the joint (synovial) fluid. Excess uric acid can also be deposited in tissues such as the kidney, leading to kidney stones or kidney failure.
The accumulation of too much uric acid is due to either increased production, decreased elimination, or a combination of both. Elevated levels of uric acid 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 a result of impaired kidney function due to kidney disease.
How is the sample collected for testing?
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.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation may be needed. Some institutions, however, recommend fasting for 4 or more hours. Follow any instructions provided and be sure to discuss with the health care provider any medications being taken before having this test performed.
Ask a Laboratory Scientist
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
KidsHealth. Blood Test: Uric Acid. Available online at http://kidshealth.org/parent/system/medical/test_uric.html through http://kidshealth.org. Accessed June 2013.
MayClinic.com. High uric acid level: Causes. Available online at http://www.mayoclinic.com/health/high-uric-acid-level/MY00160/DSECTION=causes through http://www.mayoclinic.com. Accessed June 2013.
MedlinePlus Medical Encyclopedia. Uric acid – blood. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003476.htm. Accessed June 2013.
MedlinePlus Medical Encyclopedia. Uric acid – urine. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003616.htm. Accessed June 2013.
Sources Used in Previous Reviews
Laboratory Tests & Diagnostic Procedures with Nursing Diagnoses (4th edition), Corbett, JV. Stamford, Conn.: Appleton & Lang, 1996. Pp. 105-109.
A Manual of Laboratory & Diagnostic Tests (sixth edition), Frances Fischbach, editor. Philadelphia: Lippincott Williams& Wilkins, 2000; Pp. 396-397.
Nader Rifai, PhD. Department of Laboratory Medicine, Children's Hospital, Boston, MA.
NIAMS. Fast Facts about Gout. (Revised March 2007). Available online at http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp through http://www.niams.nih.gov. Accessed June 2010.
MedlinePlus Medical Encylopedia. Uric acid - blood. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003476.htm. Accessed June 2010.
MedlinePlus Medical Encylopedia. Uric acid- - urine. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003616.htm. Accessed June 2010.
Pagana K, Pagana T. Mosby's Manual of Diagnostic and Laboratory Tests. 3rd Edition, St. Louis: Mosby Elsevier; 2006, Pg 530.
Pagana K, Pagana T. Mosby's Manual of Diagnostic and Laboratory Tests. 4th edition, St. Louis: Mosby Elsevier; 2010 Pp. 536, 998.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 1098-1101.
MayoClinic.com. High uric acid level. (Last updated September 13, 2008). Available online at http://www.mayoclinic.com/health/high-uric-acid-level/MY00160 through http://www.mayoclinic.com. Accessed June 25, 2010.
The Gout and Uric Acid Education Society. Uric Acid. Available online at http://gouteducation.org/patient/about-gout/uric-acid/ through http://gouteducation.org. Accessed June 25, 2010.
Mosby's Diagnostic and Laboratory Test Reference, 3rd Edition. Pagana and Pagana. 1997. Pp. 842-845.
(August 2002) Dincer H, Dincer A, Levinson D. Asymptomatic hyperuricemia: To treat or not to treat. Cleveland Clinic Journal of Medicine, vol. 69, no. 8, Pp 594-608. Available online at http://www.ccjm.org/content/69/8/594.full.pdf+html through http://www.ccjm.org. Accessed October 2010.
American College of Rheumatology. 2012 American College of Rheumatology Guidelines for Management of Gout. Available online at http://www.rheumatology.org/practice/clinical/guidelines/gout.asp through http://www.rheumatology.org. Accessed November 2012.
Walsh, N. ACR Puts Out Gout Guidelines. MedPage Today. Available online at http://www.medpagetoday.com/Rheumatology/GeneralRheumatology/35033 through http://www.medpagetoday.com. Accessed November 2012.