Uric Acid, Blood

Uric Acid, Blood is a topic covered in the Davis's Lab & Diagnostic Tests.

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Synonym/Acronym:
Urate.

Rationale
To monitor uric acid levels during treatment for gout and evaluation of tissue destruction, liver damage, renal function, and monitor the effectiveness of therapeutic interventions.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings
Method: Spectrophotometry.

AgeConventional UnitsSI Units (Conventional Units × 0.059)
1–30 days
 Male1.3–4.9 mg/dL0.08–0.29 mmol/L
 Female1.4–6.2 mg/dL0.08–0.37 mmol/L
1–3 mo
 Male1.4–5.3 mg/dL0.08–0.31 mmol/L
 Female1.4–5.8 mg/dL0.08–0.34 mmol/L
4–12 mo
 Male1.5–6.4 mg/dL0.09–0.38 mmol/L
 Female1.4–6.2 mg/dL0.08–0.37 mmol/L
1–3 yr
 Male and female1.8–5 mg/dL0.11–0.3 mmol/L
4–6 yr
 Male and female2.2–4.7 mg/dL0.13–0.28 mmol/L
7–9 yr
 Male and female2–5 mg/dL0.12–0.3 mmol/L
10–12 yr
 Male and female2.3–5.9 mg/dL0.14–0.35 mmol/L
13–15 yr
 Male3.1–7 mg/dL0.18–0.41 mmol/L
 Female2.3–6.4 mg/dL0.14–0.38 mmol/L
16–18 yr
 Male2.1–7.6 mg/dL0.12–0.45 mmol/L
 Female2.4–6.6 mg/dL0.14–0.39 mmol/L
19 yr–Adult
 Male4–8 mg/dL0.24—0.47 mmol/L
 Female2.5–7 mg/dL0.15–0.41 mmol/L
Adult older than 60 yr
 Male4.2–8.2 mg/dL0.25–0.48 mmol/L
 Female3.5–7.3 mg/dL0.21–0.43 mmol/L
Therapeutic target for patients with gout: Less than 6 mg/dL (SI: Less than 0.4 mmol/L).

Critical Findings and Potential Interventions

Adults

  • Greater than 13 mg/dL (SI: Greater than 0.8 mmol/L)

Children

  • Greater than 12 mg/dL (SI: Greater than 0.7 mmol/L)

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

Symptoms of acute renal dysfunction and/or chronic kidney disease associated with hyperuricemia include altered mental status, nausea and vomiting, fluid overload, pericarditis, and seizures. Prophylactic measures against the development of hyperuricemia should be undertaken before initiation of chemotherapy. Possible interventions include discontinuing medications that increase serum urate levels or produce acidic urine (e.g., thiazides and salicylates); administration of fluids with sodium bicarbonate as an additive to IV solutions to promote hydration and alkalinization of the urine to a pH greater than 7; administration of allopurinol 1 to 2 days before chemotherapy; monitoring of serum electrolyte, uric acid, phosphorus, calcium, and creatinine levels; and monitoring for ureteral obstruction by urate calculi using computed tomography or ultrasound studies. Possible interventions for advanced renal insufficiency and subsequent chronic kidney disease may include peritoneal dialysis or hemodialysis.

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