Álvarez-Lario · Rheumatology (Oxford, England) 2010 · narrative review · n=?

Uric acid and evolution.

Cited 396 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review synthesizing evolutionary and physiological hypotheses without new empirical human data

PubMed 20627967 · doi:10.1093/rheumatology/keq204 · record verified 2026-08-29

What was done

This narrative review synthesizes evolutionary hypotheses and physiological mechanisms regarding the loss of uricase activity in hominids and the retention of high circulating uric acid levels.

What was found

The abstract reports physiological observations and conceptual hypotheses rather than empirical trial data. It notes that uricase gene mutations during the Miocene epoch caused humans to have higher uric acid levels than other mammals, and 90% of uric acid filtered by the kidneys is actively reabsorbed. Proposed evolutionary benefits discussed include antioxidant activity supporting hominid life expectancy, blood pressure maintenance during low salt availability, enhancement of intelligence, and neuroprotective actions against neurodegenerative disorders.

Why it matters

The paper contextualizes uric acid beyond its clinical role as a metabolic waste product, highlighting evolutionary trade-offs between disease risks and physiological benefits such as antioxidant defense and neuroprotection.

Limits

This is a non-systematic narrative review providing theoretical synthesis without original empirical data or quantified effect sizes. Literature search methods, study counts, and quantitative parameters were not specified in the abstract.

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