When is uric acid elevated?
If uric acid is too high, this is usually due to a congenital metabolic disorder. This is then called primary hyperuricemia. In other cases, the increase in uric acid levels has other triggers, for example other diseases (such as kidney dysfunction) or certain medications. This is called secondary hyperuricemia.
Primary hyperuricemia
The genetically determined increase in uric acid is almost always due to impaired excretion of uric acid by the kidneys. Only very rarely is it due to excessive uric acid production, for example in Lesch-Nyhan syndrome.
Secondary hyperuricemia
In secondary hyperuricemia, the high uric acid levels are also caused either by reduced excretion or increased production. For example, decreased uric acid excretion results in:
- Poisoning with lead or beryllium
- metabolic disorders with hyperacidity of the blood (ketoacidosis, lactic acidosis)
- alcoholism
- certain medications such as salicylates (e.g. ASA) and dehydrating agents (e.g. furosemide)
Secondary overproduction of uric acid can be caused by the following, for example:
- Tumor diseases, especially leukemias
- Hemolytic anemia (anemia caused by increased decay of red blood cells, for example sickle cell anemia or spherocytic anemia)
- Chemotherapy or radiotherapy (for cancer patients).
Excessive uric acid levels can also develop as a result of strict fasting diets.
