It ’ s not common that reference ranges are set up to fail . Serum urate is one of those times .
Screening of any sort is not without risk . For screening to be considered valuable , tests need to be accessible , inexpensive , and reliable and need to alert us to a patient ’ s trajectory at a time when we can make a reasonable difference to their future outcome .
Serum uric acid meets many of the criteria for an effective screening test for future cardiovascular disease in low-risk patients , but we need to reconsider our acceptance of the current reference range to fully utilize this test in the general population .
Testing uric acid isn ’ t solely about assessing for the risk of gout . This value may help us identify patients at risk for cardiovascular disease at a time when we can make a significant difference to their health trajectory .
Cui
, K ., Song , Y ., Yin , D ., Song , W ., Wang , H ., Zhu , C ., Feng , L ., Fu , R ., Jia , L ., Lu , Y ., Zhang , D ., Song , C ., Yang , Y ., Dong , Q . & Dou , K . ( 2023 ). Uric Acid Levels , Number of Standard Modifiable Cardiovascular Risk Factors , and Prognosis in Patients With Coronary Artery Disease : A Large Cohort Study in Asia . Journal of the American Heart Association , e030625 . https :// doi . org / 10.1161 / jaha . 123.030625
Deng , H ., Zhang , X ., Cheng , N ., Zhang , J ., Song , C ., Sun , Y ., Hou , Z ., Li , Y ., Wang , Q ., Yin , J . & Meng , Q . ( 2023 ). Asymptomatic hyperuricemia associated with increased risk of nephrolithiasis : a cross-sectional study . BMC Public Health , 23 ( 1 ), 1525 . https :// doi . org / 10.1186 / s12889-023-16469-y
Dr . Jordan Robertson ND is the CEO of The Confident Clinician and the lead educator on critical appraisal and research .