Serum uric acid is the level of uric acid in the blood. This is a waste product from the breakdown of purines (natural compounds found in all living cells) in the body and certain foods. 

• Uric acid: a normal waste product when the body breaks down purines, which are natural substances in the body and foods like red meat, beer and shellfish.

• Serum uric acid: the measurement of how much uric acid is dissolved in your blood.

• Normal process: the body usually gets rid of uric acid through urine and bowel movements.

High levels of uric acid (hyperuricemia) can lead to health issues like gout or kidney stones. Certain medications, such as diuretics, aspirin, and niacin (as well as poor kidney function), can contribute to high uric acid levels.

Low levels of uric acid (hypouricemia) are less common but can sometimes indicate other health problems. Some studies suggest that very low levels can be linked to conditions like Parkinson’s disease or dementia.

How Uric Acid Affects Kidney Function

Uric acid plays an important role in chronic kidney disease (CKD) because it contributes to inflammation, scarring, and reduced kidney blood flow. There is a two-way relationship:

• High uric acid can damage the kidneys, and

• Damaged kidneys have a harder time removing uric acid, causing levels to rise even more.

1. Crystal Formation

When uric acid becomes highly concentrated, it can form crystals in the kidneys. These can lead to stones, blockages, infection, and long-term scarring—major contributors to kidney damage.

2. Inflammation & Oxidative Stress

High uric acid levels can promote inflammation and oxidative stress, damaging cells, blood vessels, and kidney tissue.

3. Reduced Blood Flow

Uric acid may also impair the kidney’s blood vessels, limiting blood flow and decreasing the kidney’s ability to filter waste.

4. Tubular Cell Damage

Research shows that uric acid can directly injure kidney tubular cells, leading to fibrosis (scarring) and decreased kidney function over time.

Risk factors like hypertension, diabetes, and metabolic syndrome often overlap with high uric acid, increasing the risk of kidney disease.

How to Lower High Uric Acid Levels

• Stay hydrated: drink plenty of water to help flush out the uric acid from your kidneys.

• Limit purine-rich foods: reduce or avoid red meat, organ meat, and certain seafood like anchovies and sardines.

• Avoid alcohol and sugary drinks: both alcohol (especially beer) and drinks sweetened with high fructose corn syrup can increase uric acid levels.

• Increase healthy foods: lean meats, low-fat dairy, oranges, vegetables, oats, whole grains and nuts.

• Maintain a healthy weight: this can significantly lower uric acid levels.

• Exercise regularly: walking, cycling, and swimming are all exercises that help to lower uric acid levels.

• Always discuss your diet and exercise plans with your doctor.

A doctor may prescribe medications to help manage your high uric acid. NSAIDs (nonsteroidal anti-inflammatory drugs) can help with inflammation caused by high uric acid levels. Medications, like allopurinol, can be prescribed to lower uric acid levels in the blood. This helps to monitor liver function and other blood counts.

Overview

High uric acid and kidney disease are closely linked. Each can worsen the other. If you have a history of high uric acid or gout, it's important to get tested for kidney disease. The reverse is also true- if you have kidney disease, ask your doctor about gout and high uric acid. 

Treating high uric acid, especially in the early stages of kidney disease, may help to slow its progression. Manage your diet, limit alcohol, and take prescribed medications. This can help manage high uric acid levels and their impact on your kidneys.