Uric acid (also called urate) is the end product of purine metabolism. Purines are compounds found naturally in the body and in certain foods, particularly red meat, organ meats, shellfish, and alcohol. The liver breaks purines down into uric acid, which is then filtered by the kidneys and excreted in urine. When this process is out of balance, uric acid accumulates in the blood.
The most well-known consequence of elevated uric acid (hyperuricaemia) is gout, a form of inflammatory arthritis caused by urate crystals depositing in joints. However, not everyone with high uric acid develops gout. Many people carry elevated levels for years without symptoms, though the lifetime risk of gout increases with the level and duration of hyperuricaemia.
Beyond gout, elevated uric acid is associated with an increased risk of urate kidney stones and is increasingly recognised as a marker linked to metabolic syndrome, hypertension, and chronic kidney disease. Research into whether uric acid directly contributes to cardiovascular risk or is simply correlated with other metabolic factors is ongoing.
This test is useful for investigating suspected gout, assessing the risk of kidney stones, and monitoring people already on urate-lowering therapy such as allopurinol or febuxostat. If you are being treated for gout, regular testing helps confirm whether your medication is keeping uric acid below the target level (usually below 0.36 mmol/L, or lower for those with frequent attacks).
Reference ranges differ between men and women. Women typically have lower uric acid levels than men due to the uricosuric effect of oestrogen, which increases renal excretion of urate. This difference narrows after menopause, when women's gout risk increases.
To investigate suspected gout, assess risk of urate kidney stones, monitor urate-lowering therapy (such as allopurinol), and evaluate uric acid as part of a metabolic health assessment.
