Uric acid in the blood: normal, causeshigh and low levels, what to do

Update: March 2019

Uric acid is the end product of conversion reactions.
purine bases that form the basis of DNA and RNA nucleotides,
synthesized mainly by the liver and excreted by the kidneys. Presents
is a heterocyclic compound of carbon, oxygen, nitrogen and
hydrogen.

Uric acid level determined by biochemical analysis
blood, talks about the state of health. Shifts of content given
product metabolism in the blood as upward, as well as toward
decreases depend on two processes: the formation of acid in the liver
and the time of its excretion by the kidneys, which may change due to
various pathologies.

Norm uric acid

Category The norm, mol / l
Children under 12 years old 120-330
Women under 60 200-300
Men under 60 years old 250-400
Women from 60 years 210-430
Men from 60 years 250-480
The norm in women from 90 years 130-460
The norm in men from 90 years 210-490

 How to analyze

This kind of analysis is assigned to assess the state
health during clinical examination, and in the presence of certain
diseases about which the specified indicator may increase
(diabetes, diseases of the cardiovascular system, gout, etc.).

Preparation for the study is to refrain from taking
food for eight hours, i.e. patient comes to take blood
on an empty stomach It is advisable to take the analysis before taking any drugs.
(antihypertensives, etc.). 1-2 days before analysis is necessary
completely eliminate alcohol, do not get carried away with protein-rich foods
and purines, and avoid physical overload.

For the study takes venous blood – an indicator
determined in serum. As a rule, the result will be ready
within 1 day.

Causes of elevated uric acid

Arterial hypertension

Already at stage 2 of hypertension, an increase in uric acid is observed.
Hyperuricemia causes kidney damage, contributing to
progression of the underlying disease (see review of drugs from
high pressure). On the background of antihypertensive therapy level
uric acid may return to normal without specific therapy.
If there is no such dynamics, compliance is recommended.
a special diet (see below) and an increase in physical activity, with
further hyperuricemia therapy.

Gout

When uric acid is elevated in gout, the causes are
в чрезмерном образовании пуриновых grounds. Gout more
total kidneys suffer with gradual renal formation
deficiencies as well as joints, but changes in them are not so
are active. The degree of pathological changes correlates with the level
uric acid – the higher it is, the more affected the kidneys.
In addition, hyperuricemia contributes to the development and
the progression of atherosclerosis, arterial wall lesions,
whereby people with gout are more susceptible
cardiovascular pathologies.

Endocrine diseases: acromegaly, hypoparathyroidism,
diabetes.

When hypoparathyroidism is another characteristic indicator of blood
is elevated calcium mobilized from the bones.

High blood sugar and hyperinsular hormones with
diabetes leads to pathological changes in many species
exchange, including the destruction of the nuclear material of the cells, leading
to a secondary increase in uric acid, regardless of
функции the kidneys.

Acromegaly is caused by excessive synthesis of somatotropic
hormone and manifests a disproportionate increase in body parts.
Pathology is accompanied by a violation of the exchange of purine nucleotides and
respectively, hyperuricemia.

Obesity

Increased weight often accompanies gout and diabetes,
and hypertension. There is the concept of metabolic syndrome, especially
topical in recent decades: obesity + arterial
гипертензия + diabetes. Each of these pathologies
contributes to hyperuricemia.

Elevated lipoproteins and cholesterol

A frequent precursor to overt clinical manifestations of gout and
HA is asymptomatic elevation of these two components
lipid profile. Atherosclerotic change of arteries related to
various vascular pools. Uric acid accelerates
oxidative reactions of low-density lipoproteins and lipid
peroxygenation. The resulting oxidative stress
contributes to the progression of atherosclerosis. In addition, urinary
acid is involved in platelet aggregation and adhesion, increasing the risk
coronary thrombosis.

Kidney disease, urolithiasis

Uric acid is a stone-forming substance and
promotes the formation of kidney stones. Reduced selection
kidney uric acid in a number of pathologies: polycystic kidney disease,
renal failure, nephropathy on the background of lead poisoning,
acidosis and toxicosis of pregnant women.

Blood diseases

In this case, in addition to the breakdown of blood components, there is
распад компонентов тканей с повышением уровня пуриновых grounds.
Hyperuricemia is characteristic of polycythemia, leukemia, B12-deficient
anemia, congenital and acquired hemolytic anemia.

Asymptomatic increase in uric acid levels

Every fifth citizen of Russia and Belarus has an increased
the level of this metabolic product in the blood without clinical pathology.
Based on a series of epidemiological and prospective studies
such a state is regarded as independent, powerful and
modified risk factor for cardiovascular disease and subsequent mortality.

Other pathologies

  • Diseases that occur with massive tissue breakdown,
    for example, burn shock. Against the backdrop of renal failure
    increases the time of excretion of the product of the exchange of the kidneys.
  • Lesch-Nyhan syndrome, a genetic disease resulting from
    which purines accumulate in the body. In addition to hyperuricemia,
    an increased level of acid is found in the urine.
  • Down syndrome on a background of impaired purine metabolism.
  • Erectile disfunction. Increase purine product level
    exchange in blood 6 times increases the risk of erectile
    dysfunction.

Non-specific factors leading to hyperuricemia

  • The use of a number of drugs – Furosemide, Aspirin,
    Phenothiazines, Theophylline, Adrenaline, etc.
  • Diet rich in purine bases. It is known that the second
    the name of gout is a disease of aristocrats with an excess of meat, fish,
    red wine, offal in the diet, i.e. products,
    содержащих большое количество purines.
  • Taking alcohol, especially beer and red wines rich in purines.
    In addition, alcohol adversely affects kidney and liver function,
    что также contributes to hyperuricemia.
  • Long-term diets, which result in a violation
    выделительной функции the kidneys.
  • Excessive physical exertion leads to hyperuricemia due to
    increased protein consumption, i.e. its decay.

Symptoms with increased level of analysis

When uric acid rises in the blood, the symptoms of this
states are always specific depending on the underlying cause
pathology, however, there are also characteristic manifestations that
allow to suspect hyperuricemia:

  • In adults:
    • Dental stones
    • Increased fatigue
    • Chronic fatigue
    • Specific symptoms associated with underlying pathology
  • In children: bright red spots diathesis on the hands and cheeks.

The positive effect of hyperuricemia

Paradoxically, a high level of purine metabolism in
blood, according to some researchers, a positive effect on
the body and allows you to adjust some pathological
states:

  • Numerous studies 60-70 years. confirmed higher
    level of intelligence and responsiveness in patients with acute
    hyperuricemia. Chemically, the acid is similar to
    trimethylated xanthine caffeine, therefore, as
    believed to be able to increase performance.
  • Increased acid levels prolong life
    acting as an antioxidant, blocking peroxynitrite, superoxide and
    iron catalyzed oxidation reactions. Urinary transfusion
    acid enhances serum antioxidant activity and
    improves endothelial function.
  • Uric acid is the strongest neuroprotective inhibitor
    neuroinflammation and neurodegeneration, reducing the risk of disease
    Parkinson and Alzheimer’s.

However, this positive effect is observed in acute
increased acid in the blood. Chronic hyperuricemia leads to
endothelial dysfunction and contributes to the development of oxidative
process.

What to do with an increased analysis result

Detection of elevated levels of uric acid in the blood is
the first step for further diagnosis is to install
the root cause of this condition. Fundamental is the treatment
main pathology with concurrent treatment of hyperuricemia.

  • Diet with elevated uric acid includes a decrease in the proportion
    protein foods in the diet: meat, canned meat and broths,
    smoked meat, herring, anchovies, sardines, coffee, chocolate, legumes,
    mushrooms, bananas, alcohol with a simultaneous increase in the proportion of fruit and
    овощей, кисломолочных products, яиц, круп, злаков. Recommended
    rose hips and bran.
  • Fighting overweight. Often with weight normalization
    hyperuricemia goes away without specific treatment.
  • The increase in daily drinking regime to 2-3 liters. Can
    drink pure water or fruit diluted by half with water,
    vegetable juices, fruit drinks.

Drug therapy

All drugs are used strictly as prescribed by a doctor and under his
control with regular measurements of the acid content in the blood and
urine (see medications for gout).

Diuretics

Accelerate the excretion of acid by the body with urine. Insofar as
some of them increase the concentration of uric acid in the blood,
as well as contraindicated in a number of pathologies (gout and others),
administration of drugs from this group is strictly individual and
carried out by a short course with the control of blood parameters and
urine.

Allopurinol

It inhibits the synthesis of uric acid in the liver by inhibiting
xanthine oxidase enzyme. Long-term treatment (2-3 months), requires
irreproachable adherence to the multiplicity of admission. Analogs – Milurit,
Zilorik, Foligan, Allopur, Prince, Apurin, Atisuril, Gothikur,
Uridozid, Xanturat, Uprim.

Benzobromarone

A drug that affects the function the kidneys. Renders
urikozuricheskoe action, inhibiting the absorption of acid in
proximal renal tubules, as well as inhibiting enzymes,
involved in the synthesis of purines. Analogs – Hipurik, Normurat,
Desuruk, Excurs, Azabromaron, Maksurik, Urikozurik, Urinorm.

Sulfinpyrazon

It enhances the secretion of acid through the urinary system,
especially in the initial stage of gout treatment. Analogs – Anturidean,
Pirokard, Enturan, Sulfazon, Sulfizon.

Etamide

It inhibits the reabsorption of uric acid in the kidney tubules,
thereby reducing its concentration in the blood.

Folk remedies

Broths of birch buds, nettle and lingonberry leaf are effective,
which should be taken 1 glass twice a day for
of the month.

Low uric acid – pathological causes

  • Hereditary deficiency of xanthine oxidase, in which not
    Uric acid is produced and excreted by the kidneys.
    intermediate product of exchange – xanthine. Xanthine is not displayed
    fully, partially deposited in skeletal muscle and kidney.
  • Hereditary insufficiency purine nucleoside phosphorylase –
    a disease in which purine bases are not formed.
  • Acquired lack of xanthine oxidase associated with taking
    allopurinol and liver disease.
  • Renal hypouricemia against the background of mutations of the URAT1 and GLUT9 genes,
    managing proteins responsible for the reabsorption of acid in
    proximal renal tubules.
  • Increased extracellular fluid volume at high doses
    intravenous drugs, as well as on the background of polydipsia –
    strong thirst.
  • Cerebral syndrome in which hyponatremia is observed,
    leading to hyperuricemia.
  • Parenteral nutrition – specific nutrition is aimed at
    maintenance of life and, of course, does not contain
    purines.
  • HIV infection in which uric acid deficiency occurs on
    background of brain damage.
  • Oncological diseases on the background of protein and purine deficiency
    grounds.
  • Enterocolitis due to intestinal protein absorption disorder
    epithelium.
  • In early pregnancy, when the total increases
    blood volume and uric acid is diluted
    increased volume of water in the blood.

Nonspecific factors leading to hypouricemia

  • Low-protein diet with restriction of meat, fish. This situation
    may occur in low-income people or those
    intentionally observes such restrictions.
  • Abuse of tea and coffee, which have a diuretic
    effect and promote the removal of acid from the body.
  • Reception of preparations: losartan, from groups of salicylates, hormones
    estrogen, trimethoprim, glucose, etc.

Symptoms of low uric acid levels

  • Loss of skin sensitivity;
  • Blurred vision, loss of hearing;
  • Asthenia – mood swings, tearfulness, heightened
    fatigue, insecurity, memory impairment;
  • In severe cases, paralysis with possible death.
    due to choking, multiple sclerosis with multiple lesions
    nervous tissue.

How to increase uric acid

After finding out the reasons for the condition and the exclusion of serious
pathologies can be increased given to show blood, normalizing
protein intake. In the daily diet at the rate of 1 g of protein per 1
kg of weight in women, 1.7-2.5 g of protein per kg of weight in men and no less
1.5 g of protein per kg of body weight in children.

Автор: врач-гигиенист, эпидемиолог

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