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Hyperuricemia and Chronic kidney disease

Jun Morinaga, Jiabin Zhao, Motoyoshi Endo, Tsuyoshi Kadomatsu, Keishi Miyata, Taichi Sugizaki, Yusuke Okadome, Zhe Tian, Haruki Horiguchi, Kazuya Miyashita, Nobuhiro Maruyama, Masashi Mukoyama, Yuichi Oike
PURPOSE: Angiopoietin-like proteins (ANGPTLs) 3, 4, and 8 reportedly contribute to progression of metabolic disease, a risk factor for cardiovascular disease (CVD). The purpose of this study was to investigate whether circulating ANGPTL levels are associated with CVD risk after adjustment for potential confounding factors. METHODS: We conducted a single center, cross-sectional study of 988 Japanese subjects undergoing routine health checks. Serum ANGPTL3, 4, and 8 levels were measured using an enzyme-linked immunosorbent assay...
2018: PloS One
Kang Wang, Lei Hu, Jian-Kang Chen
Recent preclinical and clinical evidence suggests that hyperuricemia (HU) is an independent risk factor for metabolic syndrome, hypertension, cardiovascular disease and chronic kidney disease. Receptor-interacting protein 3 (RIP3) is an important contributor in inducing programmed necrosis, representing a newly identified mechanism of cell death combining features of both apoptosis and necrosis. In our study, RIP3 was strongly expressed in mice with hyperuricemia. RIP3 deficiency attenuated hyperuricemia in mice, evidenced by reduced serum uric acid and creatinine and enhanced urinary uric acid and creatinine, as well as the improved histological alterations in renal sections...
March 5, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
L B Lopes, C C Abreu, C F Souza, L E R Guimaraes, A A Silva, F Aguiar-Alves, K O Kidd, S Kmoch, A J Bleyer, J R Almeida
Autosomal dominant tubulointerstitial kidney disease (ADTKD) is characterized by autosomal dominant inheritance, progressive chronic kidney disease, and a bland urinary sediment. ADTKD is most commonly caused by mutations in the UMOD gene encoding uromodulin (ADTKD-UMOD). We herein report the first confirmed case of a multi-generational Brazilian family with ADTKD-UMOD, caused by a novel heterozygous mutation (c.163G>A, GGC→AGC, p.Gly55Ser) in the UMOD gene. Of 41 family members, 22 underwent genetic analysis, with 11 individuals found to have this mutation...
March 1, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Sheyu Li, Chuan Yu, Yun Li, Qianrui Li, Rui Zhang, Qingtao Hou, Tao Zheng, Yi Ma, Miye Wang, Na Su, Ting Wu, Zhiwen Liu, Xia Sheng, Nan Li, Guanjian Liu, Yong Huang, Ting Xu, Xin Sun, Haoming Tian
AIM: To describe the characteristics of inpatients with diabetes in a tertiary hospital in China using an electronic medical record (EMR)-based database. METHODS: We identified the medical records of all patients with diabetes from nonpediatric departments of West China Hospital, Sichuan University (from February 2009 to December 2013), and extracted information on demographic, diagnosis, discharge outcome, department of discharge, laboratory test, and prescription from the EMR system...
March 7, 2018: Journal of Evidence-based Medicine
Ambreen Gul, Philip Zager
PURPOSE OF REVIEW: Multiple experimental and clinical studies have identified pathways by which uric acid may facilitate the development and progression of chronic kidney disease (CKD) in people with diabetes. However, it remains uncertain if the association of uric acid with CKD represents a pathogenic effect or merely reflects renal impairment. RECENT FINDINGS: In contrast to many published reports, a recent Mendelian randomization study did not identify a causal link between uric acid and CKD in people with type 1 diabetes...
March 1, 2018: Current Diabetes Reports
Richard J Johnson, George L Bakris, Claudio Borghi, Michel B Chonchol, David Feldman, Miguel A Lanaspa, Tony R Merriman, Orson W Moe, David B Mount, Laura Gabriella Sanchez Lozada, Eli Stahl, Daniel E Weiner, Glenn M Chertow
Urate is a cause of gout, kidney stones, and acute kidney injury from tumor lysis syndrome, but its relationship to kidney disease, cardiovascular disease, and diabetes remains controversial. A scientific workshop organized by the National Kidney Foundation was held in September 2016 to review current evidence. Cell culture studies and animal models suggest that elevated serum urate concentrations can contribute to kidney disease, hypertension, and metabolic syndrome. Epidemiologic evidence also supports elevated serum urate concentrations as a risk factor for the development of kidney disease, hypertension, and diabetes, but differences in methodologies and inpacts on serum urate concentrations by even subtle changes in kidney function render conclusions uncertain...
February 26, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ching-Chia Li, Tsu-Ming Chien, Wen-Jeng Wu, Chun-Nung Huang, Yii-Her Chou
The aim of this study was to compare the clinical characteristics of uric acid stones and their potential risk for chronic kidney disease (CKD). A total of 401 patients (196 with uric acid stone and 205 without) were enrolled from our database of patients with urolithiasis. We analyzed the clinical demographic features, stone location, urine chemistries, and renal function. There was a significant difference (p < 0.001) between the two groups in terms of age, with the higher mean age in the uric acid group...
February 28, 2018: Urolithiasis
Nicolina Stefania Carucci, Gianluca Caridi, Francesca Lugani, Claudia Barone, Giovanni Conti
Autosomal dominant tubulointerstitial kidney disease (ADTKD) belongs to a group of renal hereditary disorders linked by common findings of tubulointerstitial disease and dominant inheritance. The renal clinical phenotype is characterized by chronic kidney disease, hyperuricemia, gout, and, inconstantly, renal cysts. Uromodulin (UMOD) gene mutations are related to the clinical phenotype of ADTKD-UMOD. We describe here a novel heterozygous mutation of UMOD (c.249C>G; p.Cys83Trp) in an affected 9-year-old boy with progressive renal impairment and hyperuricemia...
February 9, 2018: Clinical Nephrology
Muhammed Khairujjaman Mazumder, Banashree Chetia Phukan, Aradhana Bhattacharjee, Anupom Borah
Chronic kidney disease (CKD) is an increasing global health burden. Disturbance in purine metabolism pathway and a higher level of serum uric acid, called hyperuricemia, is a risk factor of CKD, and it has been linked to increased prevalence and progression of the disease. In a recent study, it has been demonstrated that purine nucleotides and uric acid alter the activity of acetylcholinesterase (AChE). Thus, we hypothesize that adenine, hypoxanthine, xanthine, 2,8-dihydroxyadenine and uric acid may potentially interfere with the activity of AChE...
February 2018: Medical Hypotheses
Kunitoshi Iseki
BACKGROUND: Chronic kidney disease (CKD) is a risk factor of cardiovascular disease (CVD) and end-stage renal disease (ESRD). Early detection and management of risk factors of incidence and progression of CKD are necessary. We have been studying these risk factors among community-based screening participants in Okinawa, Japan. Okinawa was one of the longevity areas in the world; however, the incidence and prevalence of ESRD increased. In Japan, the incidence of ESRD is 2 times higher in men compared to that in women...
2018: Contributions to Nephrology
Juan C Ramirez-Sandoval, Magdalena Madero
Hyperuricemia may be a major contributor to the development or progression of chronic kidney disease (CKD). Although there is no clear cutoff uric acid (UA) value associated to the risk for kidney damage, it appears to be an increased risk as UA rises. Lifestyle interventions such as exercise, weight reduction, low consumption of purine-rich meat, or avoiding high fructose intake are recommended for all hyperuricemic patients. Lowering urate drugs such as allopurinol or febuxostat may be an option as a renoprotective agent; yet, randomized clinical trials evaluating the safety and efficacy of these drugs are limited to a small number of single-center studies...
2018: Contributions to Nephrology
Duk-Hee Kang
BACKGROUND: Although the clinical implication of hyperuricemia in chronic kidney disease has been an issue of active debate, recent data suggested a causative role of uric acid (UA) in the development of renal disease. Afferent arteriopathy, an induction of oxidative stress and an activation of local inflammation, have been regarded as the mechanisms of UA-induced renal disease, which contribute to glomerular hypertrophy and interstitial fibrosis via endothelial dysfunction. However, there have been rare studies on the direct effect of UA on phenotype transition of renal cells such as epithelial-to-mesenchymal transition (EMT) or endothelial-to-mesenchymal transition (EndoMT)...
2018: Contributions to Nephrology
Gianni Bellomo, Antonio Selvi
BACKGROUND: Uric acid (UA) is still considered a risk factor, or even a causative agent, for chronic kidney disease (CKD); however, a few, important, clinical questions remain unanswered; in particular: when and whether urate-lowering therapy should be commenced in subjects with asymptomatic hyperuricemia and/or monosodium urate crystals deposition? What is the most appropriate UA target to be achieved and how long does it need to be maintained? How does treatment need be adjusted in patients with chronic kidney disease? SUMMARY: The observational and intervention studies available do not fully answer such questions, and a treatment to target trial is required...
2018: Contributions to Nephrology
Alejandro Treviño-Becerra
This review brings together concepts of uric acid metabolism affecting renal parenchyma and its function and the current therapies to reduce hyperuricemia (HyU) and avoid renal disease progression. High uric acid plays an important role in several chronic diseases including kidney diseases such as lithiasis, gout nephropathy, and preeclampsia. In the last 30 years, it has been shown that reducing HyU with low protein and low purine diets in addition to allopurinol creates physiopathological conditions that produce a slight increase in the glomerular filtration rate (GFR)...
2018: Contributions to Nephrology
Carlo Garofalo, Toni De Stefano, Carlo Vita, Giorgia Vinci, Francesco Balia, Francesca Nettuno, Luisa Scarpati, Azzurra Sguazzo, Alessandra Sagliocchi, Mario Pacilio, Roberto Minutolo, Luca De Nicola, Silvio Borrelli
Hyperuricemia is defined as serum uric acid values greater than 6 mg/dl and could occur either due to hyperproduction or as a result of reduced renal excretion, which exceeds gut compensation. In Italy, prevalence is around 12% of the general population and increases in renal disease up to 60%. Recent experimental studies demonstrated a role of uric acid in the development of arterial hypertension and systemic arteriosclerosis, with an increase in cardiovascular risk. It also appears from observational studies that high uric acid is an independent risk factor associated with de novo onset of chronic kidney disease after adjustment of main confounding variables...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Kuang-Hui Yu, Der-Yuan Chen, Jiunn-Horng Chen, Shih-Yang Chen, Shyh-Ming Chen, Tien-Tsai Cheng, Song-Chou Hsieh, Tsu-Yi Hsieh, Pai-Feng Hsu, Chang-Fu Kuo, Mei-Chuan Kuo, Hing-Chung Lam, I-Te Lee, Toong-Hua Liang, Hsiao-Yi Lin, Shih-Chang Lin, Wen-Pin Tsai, Gregory J Tsay, James Cheng-Chung Wei, Chung-Han Yang, Wen-Chan Tsai
Gout is an inflammatory disease manifested by the deposition of monosodium urate (MSU) crystals in joints, cartilage, synovial bursa, tendons or soft tissues. Gout is not a new disease, which was first documented nearly 5,000 years ago. The prevalence of gout has increased globally in recent years, imposing great disease burden worldwide. Moreover, gout or hyperuricemia is clearly associated with a variety of comorbidities, including cardiovascular diseases, chronic kidney disease, urolithiasis, metabolic syndrome, diabetes mellitus, thyroid dysfunction, and psoriasis...
January 24, 2018: International Journal of Rheumatic Diseases
Tsai-Hung Wu, Ko-Jen Li, Chia-Li Yu, Chang-Youh Tsai
Tamm-Horsfall protein (THP), or uromodulin (UMOD), is an 80-90-kDa phosphatidylinositol-anchored glycoprotein produced exclusively by the renal tubular cells in the thick ascending limb of the loop of Henle. Physiologically, THP is implicated in renal countercurrent gradient formation, sodium homeostasis, blood pressure regulation, and a defense molecule against infections in the urinary system. Investigations have also revealed that THP is an effective binding ligand for serum albumin, immunoglobulin G light chains, complement components C1 and C1q, interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, and interferon-γ through its carbohydrate side chains for maintaining circulatory and renal immune homeostasis...
January 22, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Yan Liu, David Goldfarb, Tarek M El-Achkar, John C Lieske, Xue-Ru Wu
Expression of Tamm-Horsfall protein (THP or uromodulin) is highly restricted to the kidneys' thick ascending limb (TAL) of loop of Henle. Despite the unique location and recent association of THP gene mutations with hereditary uromodulin-associated kidney disease and THP single nucleotide polymorphisms with chronic kidney disease and hypertension, the physiological function(s) of THP and its pathological involvement remain incompletely understood. By studying age-dependent changes of THP knockout (KO) mice, we show here that young KO mice had significant salt and water wasting but were partially responsive to furosemide, due to decreased luminal translocation of Na-K-Cl cotransporter 2 (NKCC2) in the TAL...
January 10, 2018: American Journal of Physiology. Renal Physiology
Bo-Lin Pan, Song-Seng Loke
OBJECTIVE: The relationship between decreased bone mineral density (BMD) and chronic kidney disease (CKD) is controversial. The associations among metabolic syndrome (MetS), serum uric acid and CKD are also unclear. We aimed to investigate the relationship between decreased BMD, MetS, serum uric acid and CKD in a general population. METHODS: A total of 802 subjects who visited a medical center in Southern Taiwan and underwent a BMD measured by dual-energy X-ray absorptiometry (DEXA) during a health examination were enrolled in this retrospective cross-sectional study...
2018: PloS One
Ba Hamadou, Jérôme Boombhi, Félicité Kamdem, Adeline Fitame, Sylvie Ndongo Amougou, Liliane Kuate Mfeukeu, Chris Nadège Nganou, Alain Menanga, Gloria Ashuntantang
Background: The prevalence of chronic kidney disease (CKD) is increasing worldwide due to an increase in the risk factors such as hypertension. The greatest burden is in low-income settings, coupled with late diagnosis and limited management resources. This work aimed at studying the prevalence and risk factors of CKD in a group of patients with hypertension in the Savanah zone in Sub-Saharan Africa (SSA). Methods: We carried out a cross-sectional study between January and May 2016 in the regional Hospital of Garoua-Cameroon...
December 2017: Cardiovascular Diagnosis and Therapy
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