Definition

A uric acid test measures the level of uric acid in the blood or urine. Uric acid is a waste product generated during the metabolic breakdown of purines, substances found naturally in the body and certain foods and drinks, such as red meat, chicken liver, organ meats, and alcoholic beverages like beer. Additionally, uric acid can result from the breakdown of old or dead cells, releasing purines into the bloodstream.

Most uric acid in the body is produced by the liver and the mucosal lining of the intestines in the lower digestive tract. Typically, it dissolves into the blood and is filtered by the kidneys, where it is excreted through urine. A small amount is also expelled through feces.

Uric acid tests are often linked to the diagnosis of gouty arthritis, an inflammatory joint disease. This condition arises when the body produces excessive uric acid or fails to excrete it effectively. When uric acid levels exceed normal limits (hyperuricemia), crystals can form in the joints, leading to gouty arthritis. Common symptoms include stiffness, pain, swelling, redness, and discomfort, particularly in the joints of the fingers or toes.

Elevated uric acid levels can also cause other complications, such as kidney stones or kidney failure. Symptoms of these conditions may include intermittent lower back pain, bloody urine, a frequent urge to urinate, or the passage of sand-like particles in the urine.

Indications

A uric acid test may be recommended in the following situations:

• To confirm a diagnosis of gouty arthritis when symptoms and clinical signs are present.
• To monitor the effectiveness of gouty arthritis treatment.
• To identify or rule out the cause of recurrent kidney stones.
• To track uric acid levels in patients undergoing certain cancer treatments, such as chemotherapy or radiotherapy, which can raise uric acid levels due to cancer cell destruction.
• As part of routine health screening during medical check-ups.

Contraindications

There are no specific conditions or contraindications preventing a uric acid test from being performed.

Preparation Before the Test

No special preparation is required before undergoing a uric acid test, and fasting is unnecessary. However, it is advisable to consult your doctor beforehand, as certain medications, such as metamizole or non-opioid painkillers, can interfere with the test results and may not accurately reflect your condition.

Test Procedure

The uric acid test typically uses 0.25–0.5 ml of blood serum. The sample is drawn from a vein and collected into a special tube. Laboratory staff performing the procedure wear gloves and personal protective equipment (PPE) to ensure safety and hygiene.

Before drawing blood, an elastic band is tied around the upper arm, and the puncture area, usually in the crease of the elbow, is cleaned with antiseptic gauze. After the blood is drawn and placed in a special tube, the elastic band is removed, and the puncture site is pressed and cleaned with antiseptic gauze. This process takes only a few minutes. The collected blood sample is analyzed in a laboratory using specialized equipment, and results are typically available within a few hours.

Normal and Abnormal Values

The normal uric acid range varies by age and gender. The following is the range of normal and abnormal values ​​of uric acid blood test.

Adult Men

Adult women

Children

Infants or Neonates

It is important to note that the normal range may vary slightly between laboratories due to differences in testing equipment and methods. In Indonesia, according to the guidelines set by the Indonesian Rheumatology Association, hyperuricemia is diagnosed when blood uric acid levels exceed 6.8 mg/dL.

Results and Recommendations (Further Testing)

Low

If your uric acid test results indicate low levels, it’s essential to consult a doctor. Low uric acid levels can be associated with certain medical conditions, such as:

• Wilson's disease: A rare genetic disorder causing excessive copper buildup in organs like the liver, heart, and cornea.
• Fanconi syndrome: A condition where substances meant to be reabsorbed by the kidneys are instead lost in the urine.
• Acromegaly: Excessive growth hormone levels leading to abnormal growth of body tissues and bones.
• Celiac disease: A chronic condition causing damage to the small intestine due to gluten sensitivity.
• Xanthinuria: A rare genetic disorder affecting purine metabolism.

Avoid self-diagnosis and seek a doctor’s consultation for a thorough evaluation and any necessary tests if you have symptoms or concerns.

Normal

Normal uric acid test results suggest that you’re maintaining a healthy lifestyle. Continue your current habits to help prevent conditions related to high uric acid levels, such as gout arthritis or kidney problems.

High

If your test results show elevated uric acid levels, consult a doctor promptly. Your doctor may suggest dietary and lifestyle changes or initiate drug therapy to manage and reduce your uric acid levels.

High uric acid levels can be linked to various medical conditions, such as:

• Gout arthritis
• Kidney failure
• Hypothyroidism
• Chronic kidney disease
• Parathyroid disorders

Again, self-diagnosis is not advised. Consult a doctor for a proper assessment and to address any complaints you may have.

According to the Guidelines for the Diagnosis and Management of Gout, there are several steps you can take to help lower uric acid levels. You should avoid consuming foods and drinks rich in purines, such as organ meats (liver, gizzards, etc.), artificial sweeteners, and beer, stay hydrated by drinking at least 2 liters of water daily, and engage in light physical activity, such as jogging or walking, for 30–60 minutes, 3–5 times a week.

Consult the Right Doctor

For adults, uric acid test results should be reviewed with a general practitioner who may recommend further tests or initiate treatment. Internists or rheumatology specialists can provide more detailed care and management for uric acid-related issues. For pediatric patients, any abnormal results should be discussed with a pediatrician.

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