Uric acid is the end product of purines and nucleic acid metabolism in man. Uric acid emanates from two routes; from oxidation of purine moieties of degraded nucleic acids (i.e Ribonucleic and deoxyribonucleic acids),from glycine via a direct pathway not involving nucleic acid. Uric acid is filtered by glomerulli and both reabsorped and secreted by the renal tubules. Reasons for requesting uric acid assay include; suspected gout and uric acid nephropathy, renal failure.
Total daily output of uric acid depends partly on the purine content of the diet. Uric acid excretion is diminished when the diet has low purine content, low protein content. Normal levels of serum uric acid is 1-5mg/100ml and it rises to between 8-15mg/100ml in Gout. Diseases such as leukaemia, myeproliferative disorders, plasma cell myeloma and severe haemolytic anaemia, there is considerable breakdown of nuclei of leukocytes. This ultimately results in elevated serum uric acid level.
Gout is a chronic disorder of purine degradation. Types include ; acute gout and chronic gout. Features of gout is as follows viz; hyperuricemia, deposits of sodium monourates in the articular structures, and recurring attacks of acute arthritis with deposits of crystals of monosodium urate in and around the structures the affected joint.
Treatment of gout include the following; restrict the consumption of organ meats since these are rich in purines. Acute gout is treated with drugs such as colchine, phenylbutazone and indomethacin.Chronic gout is characterized by increased excretion of uric acid can be treated with drugs that discourage reabsorption of urates. Drugs such as probenecid (Benemid) and salicylates. Allopurinol inhibits the enzyme xanthine oxidase and this ultimately reduces uric acid synthesis.
Increased secretion of uric acid lowers serum uric acid levels in as much as reabsorption by the renal tubules is not encouraged.
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