Uric Acid in Urine

What To Think About

• Having a high uric acid level does not mean that you have gout. If your uric acid level is high and you do not have any other symptoms, you will not need to take any medicine to decrease your uric acid level.
• If you have kidney disease or have had a problem with kidney stones, your doctor may start treatment with a medicine, such as allopurinol, even if your uric acid levels are not too high.
• Uric acid also may be measured in blood. For more information, see the medical test Uric Acid in Blood.
• About 10% of kidney stones are made of uric acid. These white or orange stones are difficult to see on an abdominal X-ray. Uric acid stones can form when urine has a low pH (is very acidic). People who have gout are at high risk of developing uric acid kidney stones. Allopurinol (such as Aloprim or Zyloprim) may be prescribed without performing a 24-hour uric acid urine level if a person has significantly impaired kidney function or tophi. Tophi are chalky, white accumulations of uric acid crystals that build up in the soft tissue of a joint, often occurring in the joints of fingers. Tophi may also develop in the cartilage of the external ear, the back of the fingers, or the elbow.
• The chance of having high levels of uric acid in the urine increases under some conditions, such as from receiving chemotherapy for some types of cancer.
• If the urine uric acid is greater than 750 mg per 24-hour urine sample, a person with gout is usually treated with a medicine such as allopurinol (for example, Aloprim or Zyloprim) that decreases the body's production of uric acid. A person in this situation is called an "overproducer."
• If the urine uric acid is less than 750 mg per 24-hour urine sample, a person with gout is often treated with a medicine such as probenecid (for example, Benemid or Probalan) that increases uric acid elimination by the kidneys. A person in this situation is called an "underexcretor."
• A person with tophi or uric acid kidney stones will be treated for high uric acid levels no matter what the results of the uric acid test are.

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Author:	Maria G. Essig, MS, ELS	Last Updated: October 31, 2007
Medical Review:	E. Gregory Thompson, MD - Internal Medicine Stanford M. Shoor, MD - Rheumatology
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