and the Kidneys

Uric  Acid

Understanding Uric Acid in Lesch-Nyhan disease (Syndrome)

Living with Lesch-Nyhan disease (Syndrome) means learning about how the body processes certain natural substances. One of the most important to understand is uric acid. Keeping uric acid levels within a healthy range helps prevent pain, kidney problems, and long-term complications — and it’s something parents and care teams can work together to manage.

What Is Uric Acid?

🧡 “Orange Sand” in the Diaper - Before any movement or behavioral symptoms appear, some parents notice a reddish-orange, shiny, sand-like substance in their baby’s diaper. This occurs when uric acid crystals form in the urine and can be one of the earliest visible signs of Lesch-Nyhan Disease (Syndrome). If you notice this, share your observation with your child’s pediatrician — early awareness can help guide testing, diagnosis, and support.
💧 What "orange Sand" can indicate: “Orange sand” may be a sign of dehydration and/or high uric acid levels. Ensuring your child stays well hydrated and sharing observations with your pediatrician can help prevent complications.

Uric acid is a natural chemical your body makes when it breaks down purines — substances found in all our cells and in some foods. Normally, the body filters uric acid through the kidneys and removes it in urine.

In Lesch-Nyhan disease (Syndrome), the enzyme HGprt (hypoxanthine-guanine phosphoribosyltransferase) doesn’t work properly. This enzyme helps recycle purines, and when it’s missing or low, uric acid builds up in the blood and urine.

Why Uric Acid Levels Matter

Too much uric acid in the body can lead to several problems over time, including:

  • Kidney stones or “orange sand” crystals in the urine (sometimes seen in infants’ diapers).

  • Joint pain or swelling, similar to gout.

  • Discomfort or urinary tract issues due to crystal buildup.

  • Long-term kidney damage if uric acid stays high for too long.

By keeping uric acid levels within a healthy range, families can help prevent these complications and support better overall comfort and health.

Monitoring and Management

Your child’s doctor will usually check uric acid levels with simple blood and urine tests on a regular schedule.


If levels are high, treatment may include:

  • Allopurinol, a common medication that helps lower uric acid production.

  • Adequate hydration, encouraging plenty of fluids throughout the day.

  • Balanced nutrition, avoiding excessive purine-rich foods when recommended by your care team.

Even with treatment, it’s important to keep track of any changes in urine color, discomfort, or new symptoms — and share them with your medical provider.

⚠️ When Uric Acid Is Too Low: Xanthine Stones

While much of the focus is on high uric acid, it’s also possible for levels to become too low, especially if medications like allopurinol are used in higher doses. When uric acid drops too far, the body can form xanthine crystals or stones.

  • Xanthine stones are less soluble in water than uric acid crystals, making them harder to pass and potentially more painful.

  • They can cause urinary discomfort, blockages, or kidney problems if not monitored.

  • Symptoms may include changes in urine color, pain, or difficulty urinating.

How families can help:

  • Work closely with your child’s doctor to keep uric acid in the target range — not too high, not too low.

  • Ensure adequate hydration so crystals are less likely to accumulate.

  • Report any unusual signs, like pain during urination or cloudy urine, to your healthcare team promptly.

Balancing uric acid is a careful process, but regular testing and good communication with your medical team can help prevent complications from either extreme.

What Parents Can Watch For

  • Reddish-orange “sand” or crystal-like particles in the diaper or urine.

  • Changes in urination or signs of discomfort.

  • Unexplained irritability or crying, which may signal pain.

If you notice any of these signs, it’s best to contact your doctor promptly

Working Together for Long-Term Health

Managing uric acid is a team effort. Parents, pediatricians, nephrologists, and metabolic specialists all play a role in helping children with Lesch-Nyhan stay healthy and comfortable.

You don’t have to do it alone — Love Never Sinks is here to help families learn, connect, and find the resources they need to navigate care confidently.

Quick Takeaway

Keeping uric acid within a healthy range helps protect the kidneys, prevent pain, and support better quality of life for individuals with Lesch-Nyhan Syndrome.

🧬 What It Is- Uric acid is a natural waste product the body makes when breaking down purines. In Lesch-Nyhan Syndrome, the HGprt enzyme doesn’t recycle purines properly — causing uric acid to build up in the blood and urine.
💡 Why It Matters- Too High: Kidney stones and “orange sand” in urine Joint pain or swelling Discomfort and potential long-term kidney issues Too Low: Can lead to xanthine stones, which are less water-soluble and more painful than uric acid crystals May cause urinary discomfort or blockages Symptoms include pain during urination, cloudy urine, or changes in urination patterns
🩺 How to Monitor It- Regular blood and urine tests with your doctor Medication management, like allopurinol — carefully dosed to avoid levels being too low. Drink plenty of water every day to stay hydrated and help flush crystals from the body Watch for early signs like orange sand in diapers, urinary discomfort, or unusual urine changes
💛 Remember- Balancing uric acid is key: not too high, not too low. Staying well hydrated, monitoring levels, and working closely with your medical team can prevent painful crystals and protect long-term kidney health.
Illustration of a zebra wearing orange sunglasses, with a logo that reads 'LNS Love Never Sinks' and a cross. The image includes the text 'LESCH-NYHAN' and a red heart, surrounded by a circular message about raising awareness for Lesch-Nyhan syndrome.

If your child has recently been diagnosed with Lesch-Nyhan, it's important to understand the signs and symptoms associated with the condition. This information can help you better understand the individual’s needs and advocate for appropriate care.

Children and adults with Lesch-Nyhan may experience a variety of symptoms, including self-injurious behavior, neurological problems, motor difficulties, kidney stones, and gout. However, it's important to remember that each individual's experience with the condition will be unique.

If you have any questions or concerns about your child's or adult’s symptoms, please talk to your doctor. They can help you understand the individual’s specific needs and provide appropriate care.

Return to Health Tips
Return to Signs and Symptoms