Lexicon
Uric Acid
Definition
How it works
The kidney plays a dominant role in uric acid excretion, removing approximately 70% of the uric acid produced each day while the remaining 30% is excreted from the intestine, so hyperuricemia occurs when production exceeds excretion. [3] Uric acid has antioxidant properties that may be protective but can also be pro-oxidant depending on its chemical microenvironment, and hyperuricemia independent of crystal formation has been linked with hypertension, atherosclerosis, and insulin resistance. [4] Genetic variability in urate transporters such as URAT1 and GLUT9 is strongly related to variation in serum urate levels, and decreased renal or intestinal excretion is the primary mechanism of hyperuricemia in most people. [5] [4]
Connected concepts
How it's measured
Serum uric acid has been reported as a predictive marker for cardiovascular outcomes in several clinical investigations. [1] In gout, a treat-to-target management strategy titrates urate-lowering therapy according to serial serum urate measurements. [6] Premenopausal women have lower uric acid levels, likely due to hormonal effects, which suggests a potential need for gender-specific definitions when assessing cardiovascular risk. [7]
What levels mean
Hyperuricemia can be defined as a serum uric acid level greater than 6.8 mg/dL (404 micromol/L), above which urate crystals may form and cause gout. [2] The 2020 American College of Rheumatology guideline strongly recommends a treat-to-target strategy maintaining serum urate at less than 6 mg/dL. [6] The EULAR recommendations advise maintaining serum uric acid below 6 mg/dL (360 micromol/L), and below 5 mg/dL (300 micromol/L) in those with severe gout. [8]
Community knowledge
## Uric Acid As Energy Marker
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- 1.Saito Y, Tanaka A, Node K, Kobayashi Y. Uric acid and cardiovascular disease: A clinical review. J Cardiol · 2021
- 2.Ben Salem C, Slim R, Fathallah N, Hmouda H. Drug-induced hyperuricaemia and gout. Rheumatology (Oxford) · 2017
- 3.Yanai H, Adachi H, Hakoshima M, Katsuyama H. Molecular Biological and Clinical Understanding of the Pathophysiology and Treatments of Hyperuricemia and Its Association with Metabolic Syndrome, Cardiovascular Diseases and Chronic Kidney Disease. Int J Mol Sci · 2021
- 4.So A, Thorens B. Uric acid transport and disease. J Clin Invest · 2010
- 5.Ahn EY, So MW. The pathogenesis of gout. J Rheum Dis · 2025
- 6.FitzGerald JD, Dalbeth N, Mikuls T, Brignardello-Petersen R, Guyatt G, Abeles AM, Gelber AC, Harrold LR. 2020 American College of Rheumatology Guideline for the Management of Gout.
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