Biomarkers · Renal & Purine
Serum Uric Acid
Both low and high values go with higher risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 16% higher risk of death. We found the same pattern in NHANES
Serum Uric Acid and risk of death
Published curve higher than the NHANES fitNHANES fit higher
Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
Serum Uric Acid by age and sex
Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.
The percentiles as a table
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 3.10 | 4.30 | 5.10 | 6.20 | 7.80 | 1,429 | NHANES 2017-2018 |
| All | 40-59 | 3.30 | 4.30 | 5.20 | 6.10 | 7.80 | 1,548 | NHANES 2017-2018 |
| All | 60+ | 3.40 | 4.60 | 5.60 | 6.60 | 8.00 | 1,890 | NHANES 2017-2018 |
| All | all | 3.30 | 4.40 | 5.30 | 6.30 | 7.90 | 4,867 | NHANES 2017-2018 |
| Men | 20-39 | 4.20 | 5.10 | 5.90 | 6.80 | 8.26 | 684 | NHANES 2017-2018 |
| Men | 40-59 | 4.10 | 5.10 | 5.90 | 6.80 | 8.40 | 723 | NHANES 2017-2018 |
| Men | 60+ | 3.90 | 5.20 | 6.00 | 7.00 | 8.20 | 958 | NHANES 2017-2018 |
| Men | all | 4.10 | 5.10 | 5.90 | 6.90 | 8.30 | 2,365 | NHANES 2017-2018 |
| Women | 20-39 | 2.90 | 3.61 | 4.40 | 5.10 | 6.60 | 745 | NHANES 2017-2018 |
| Women | 40-59 | 3.00 | 3.80 | 4.50 | 5.30 | 6.60 | 825 | NHANES 2017-2018 |
| Women | 60+ | 3.20 | 4.30 | 5.20 | 6.10 | 7.70 | 932 | NHANES 2017-2018 |
| Women | all | 2.90 | 3.90 | 4.70 | 5.50 | 7.10 | 2,502 | NHANES 2017-2018 |
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in Serum Uric Acid, study by study
7 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| diet | Elimination of sugar-sweetened (high-fructose) beverages | Highest vs lowest sugar-sweetened beverage intake associated with 0.18 mg/dL higher serum uric acid (95% CI 0.11-0.25); cross-sectional data | meta-analysis | Ebrahimpour-Koujan S, et al. Consumption of sugar-sweetened beverages and serum… |
| nutraceutical | Vitamin C supplementation (500-1000 mg/day) | Lowered serum uric acid by -0.35 mg/dl (95% CI -0.66, -0.03) vs control; median dose 500 mg/day (meta-analysis of RCTs) | meta-analysis | Juraschek SP, et al. Effect of oral vitamin C supplementation on serum uric… |
| pharmacologic | Urate-lowering drug therapy (e.g. Allopurinol) in hypertension with hyperuricemia | Urate-lowering drugs reduced serum uric acid by 3.1 mg/dL (95% CI 2.4 to 3.8) vs placebo in hypertensive hyperuricemic patients | meta-analysis | Gois PHF, et al. Pharmacotherapy for hyperuricemia in hypertensive patients… |
| pharmacologic | Xanthine oxidase inhibitors (Febuxostat 80-120 mg / Allopurinol 300 mg) in gout | Serum urate <6.0 mg/dL reached in 53% (febuxostat 80 mg), 62% (febuxostat 120 mg) and 21% (allopurinol 300 mg) | RCT | Becker MA, et al. N Engl J Med. 2005;353:2450-2461. |
| pharmacologic | Empagliflozin 10 mg daily in adults with heart failure with preserved ejection fraction | Serum uric acid -0.99 mg/dL (SE 0.03) vs placebo at 4 weeks, sustained through follow-up; gout events -38% | RCT | Doehner W, et al. JACC Heart Fail. 2024. Uric Acid and SGLT2 Inhibition With… |
| pharmacologic | Urate transporter-1 inhibitor verinurad 12 mg plus allopurinol 300 mg once daily for 32 weeks in HFpEF with uric acid >6 mg/dL | Serum uric acid -59.6% (95% CI -64.4 to -54.2) vs +0.8% with placebo at week 32 | RCT | Kitzman DW, et al. JAMA Cardiol. 2024. Verinurad Plus Allopurinol for Heart… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| diet | Beer and liquor consumption | +0.46 mg/dL serum uric acid per daily serving of beer and +0.29 mg/dL per serving of liquor; wine not associated | cross-sectional | Choi HK, et al. Beer, liquor, and wine consumption and serum uric acid level… |
| pharmacologic | Thiazide diuretic therapy (hydrochlorothiazide) | Hydrochlorothiazide significantly increased serum urate vs placebo over a 52-week period (effect size not reported) | RCT | Garcá Puig J, et al. Hydrochlorothiazide versus spironolactone: long-term… |
Sources
- Risk curve: Cho SK 2018 (PMID 29694719): all-cause HR 2.39 (1.57-3.66) men: highest uric acid category (>=9.5 mg/dl) vs sex-specific reference category (women: >=8.5 mg/dl, HR 3.77, 1.17-12.17). Scaled to US values (NHANES).
- Cho SK, Chang Y, Kim I, Ryu S. U-Shaped Association Between Serum Uric Acid Level and Risk of Mortality: A Cohort Study. Arthritis Rheumatol. 2018;70(7):1122-1132.
- Rabbani et al. Higher serum uric acid levels and risk of all-cause mortality in general population: a systematic review and meta-analysis. Metabolism open. 2025;26:100371.
- NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map Serum Uric Acid against another biomarker.
Related markers: Alpha-1-Microglobulin · Beta-2 Microglobulin · Beta-Trace Protein (BTP) · Blood Urea Nitrogen (BUN) · Estimated Glomerular Filtration Rate (eGFR) · Kidney Injury Molecule-1 (KIM-1) · Neutrophil Gelatinase-Associated Lipocalin (NGAL) · Renal Artery Calcification