Screenings if you have gout

How gout is confirmed

NICE says to measure the serum urate level in people with symptoms and signs of gout to confirm the clinical diagnosis (serum urate level of 360 micromol/litre [6 mg/dl] or more). If the level is below that during a flare and gout is strongly suspected, NICE says to repeat the measurement at least 2 weeks after the flare has settled. (NICE NG219) The NHS says a GP may do a test to measure how much uric acid is in your blood, and if the test is still unclear, may refer you to a specialist (rheumatologist) for further tests, such as a sample of fluid from the joint or a scan. (NHS) MedlinePlus says a uric acid level in the blood over 7.2 mg/dL is high, but that not everyone with a high uric acid level has gout. (MedlinePlus)

Uric acid (urate) checks over time

NICE says to consider a follow-up appointment after a gout flare has settled to: (NICE NG219)

measure the serum urate level
provide information about gout and how to reduce the risk of future flares
assess lifestyle and comorbidities, including cardiovascular risk factors and chronic kidney disease (CKD)
review medications

While urate-lowering treatment is being adjusted, NICE uses monthly serum urate levels, and for people continuing that treatment after reaching their target level, it says to consider checking serum urate once a year. (NICE NG219) The ACR guideline strongly recommends that treatment for all patients on urate-lowering therapy be guided by serial serum urate measurements. (ACR 2020) See questions to ask your doctor.

Kidney function

NICE names chronic kidney disease among the comorbidities to assess at follow-up after a flare, and says to consider referring a person with gout to a rheumatology service if they have CKD stages 3b to 5 or have had an organ transplant. (NICE NG219) MedlinePlus says gout may develop in people with kidney disease, lists kidney stones and deposits in the kidneys, leading to chronic kidney failure, among its complications, and says high levels of uric acid in the blood are associated with increased risk for kidney disease. (MedlinePlus) See kidney disease screening, kidney test results and screenings if you have kidney disease.

Blood pressure, cholesterol and heart risk

NICE says to assess cardiovascular risk factors at follow-up after a gout flare, and lists comorbidities such as CKD or hypertension among the risk factors for gout to explain at diagnosis. (NICE NG219) The NHS says you might have a higher chance of getting gout if you have high cholesterol, high blood pressure, kidney problems, osteoarthritis or diabetes. (NHS) See blood pressure screening, screenings if you have high blood pressure, cholesterol test by age and heart screenings by age.

Blood sugar and weight

MedlinePlus says gout may also develop in people with diabetes, kidney disease, obesity, sickle cell anemia and other anemias, and leukemia and other blood cancers. (MedlinePlus) The NHS lists being overweight and diabetes among the things that raise the chance of getting gout. (NHS) See diabetes screening, A1C and blood sugar test results and screenings if you have obesity.

Usual screening on schedule

Gout does not change the general schedules for cancer and other screening in the sources on this page. (NICE NG219)(MedlinePlus) See preventive screenings for older adults, cancer screenings by age and screenings by age and gender.

When to contact a provider

MedlinePlus, gout, when to contact a medical professional: (MedlinePlus)

Contact your provider if you have symptoms of acute gouty arthritis or if you develop tophi.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have a sudden pain and swelling in a joint and the pain is getting worse, you also have a very high temperature (or you feel hot, cold or shivery), or you also feel sick or cannot eat, because these symptoms could mean you have an infection inside your joint. (NHS)

Where they differ:

What counts as a high level. NICE confirms gout at a serum urate of 360 micromol/litre (6 mg/dl) or more; (NICE NG219) MedlinePlus calls a blood uric acid level over 7.2 mg/dL high. (MedlinePlus)
How often urate is checked. NICE names monthly checks while treatment is adjusted and a yearly check once the target is reached; (NICE NG219) the ACR recommends serial serum urate measurements and says titration should be individualized. (ACR 2020)
Heart and kidney checks. NICE ties an assessment of cardiovascular risk factors and CKD to follow-up after a flare; (NICE NG219) the ACR says its guideline does not directly address the impact of gout on cardiovascular disease, hypertension or CKD. (ACR 2020)

Your doctor decides what your result means for you.

Questions people ask

How often is uric acid checked if you have gout?

NICE says to consider a follow-up appointment after a gout flare has settled to measure the serum urate level. For people continuing urate-lowering treatment after reaching their target level, NICE says to consider checking serum urate once a year. While that treatment is being adjusted, NICE uses monthly serum urate levels. (NICE NG219)

What uric acid level is high?

NICE uses a serum urate level of 360 micromol/litre (6 mg/dl) or more to confirm the clinical diagnosis of gout. MedlinePlus says a uric acid level in the blood over 7.2 mg/dL is high, but that not everyone with a high uric acid level has gout. (NICE NG219) (MedlinePlus)

Are the kidneys checked if you have gout?

NICE says the follow-up after a gout flare should assess comorbidities, including chronic kidney disease (CKD). MedlinePlus lists kidney stones and deposits in the kidneys, leading to chronic kidney failure, among the complications of gout. (NICE NG219) (MedlinePlus)

Does gout change the usual cancer screening schedule?

The sources on this page do not set a different schedule for cancer or other routine screening in people with gout. (NICE NG219) (MedlinePlus)