Low uric acid level

Hello Dr. Agar,

I used to do nocturnal dialysis with a low flux dialyzer & high flux dialyzer on alternate nights. Recently, in an effort to treat my bone pain, my nephrologist asked me to switch completely to high flux dialyzers. Within a couple of weeks of this, my uric acid level plummeted. It hs been reported as “<1.5” mg/dL and the normal is 3.5 to 7.2 mg/dL.

Researching on the internet I didn’t find any useful information about this. I was wondering if this was generally harmful and if I need to switch back to my alternate nights with a low flux dialyzer.


Dear Kamal

I don’t think this is an issue at all. I wouldn’t anxious about it.

Further, I would be thankful it is one issue you no longer have to worry about. I know of no clinical issues or problems that relate to or a caused by hypouricaemia and I would probably be saying ‘thanks for small mercies!’

I presume this is a post-dialysis level and, if so, it would soon rebound back up into the normal range prior to the next run.

One small question … were all the other biochemistries ‘low’ in that blood sample … occasionally our patients will muck up their post dialysis bloods and return saline-diluted samples for analysis. Just a thought. However, if all the other bloods were ‘in range’ and just the urate level was low … don’t lose any sleep. All’s good.

And … NO … stick with your high flux membranes. We use them (we have ALWAYS used them) in all our patients as there is good evidence that B2M is better cleared by high flux dialysers = a benefit not to be ignored or minimised.

Hello Dr. Agar,

Thanks for you response. Yes, the sample was post dialysis. The other tests came out quite alright. Good to know that it is not a problem!