What Is the Normal Range for Uric Acid Levels and What Affects Them?

Uric acid is a natural byproduct of purine metabolism in the body, and it's primarily excreted through urine. In healthy individuals, urine contains mostly urea and only small amounts of uric acid. When purines from both internal cell turnover and dietary sources are broken down, they form uric acid, which is then filtered out by the kidneys. The standard laboratory method used to measure uric acid levels is the uricase-peroxidase coupled assay. For adults, the normal serum uric acid range typically falls between 90 and 420 μmol/L.

Understanding Hyperuricemia and Its Link to Gout

Elevated uric acid levels—known as hyperuricemia—are most commonly associated with gout, a painful form of arthritis caused by the deposition of urate crystals in joints. However, it's important to note that not all individuals with high uric acid develop gout, and conversely, some gout patients may have normal uric acid levels during an acute flare-up. This means that while hyperuricemia increases the risk of gout, it doesn't guarantee its onset. When someone has persistently high uric acid without symptoms of gout or kidney stones, the condition is referred to as asymptomatic hyperuricemia.

Medical Conditions That Influence Uric Acid Production

Rapid cell turnover and increased nucleic acid breakdown can significantly raise uric acid levels. This often occurs in certain medical conditions such as leukemia, other aggressive cancers, multiple myeloma, and polycythemia vera (a type of blood disorder involving excessive red blood cell production). In these diseases, large numbers of cells die and regenerate quickly, releasing purines that are converted into uric acid.

The Impact of Cancer Treatments on Uric Acid

Chemotherapy and radiation therapy can cause tumor lysis syndrome, especially in patients with fast-growing cancers. As cancer cells are destroyed rapidly during treatment, they release their contents—including purines—into the bloodstream, leading to a sudden spike in uric acid. Without proper management, this can overwhelm the kidneys and potentially lead to acute kidney injury.

Kidney Function and Uric Acid Regulation

The kidneys play a crucial role in maintaining uric acid balance. When kidney function declines, the organ's ability to filter and eliminate uric acid diminishes, resulting in elevated serum levels. Chronic kidney diseases such as chronic nephritis, advanced renal tuberculosis, pyelonephritis, and hydronephrosis (kidney swelling due to urine buildup) are frequently linked with increased uric acid concentrations.

In fact, impaired renal excretion is one of the most common causes of hyperuricemia. Over time, high uric acid can further damage kidney tissues, creating a vicious cycle that worsens both kidney health and metabolic balance. Regular monitoring of uric acid levels is therefore essential for patients with existing kidney conditions or those at risk due to lifestyle, genetics, or comorbidities.

Maintaining healthy uric acid levels involves a combination of balanced diet, adequate hydration, weight management, and appropriate medical care—especially for individuals with underlying health issues. Early detection and intervention can help prevent complications like gout, kidney stones, and progressive renal disease.