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Uric Acid Renal Function

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204 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
William B White, Kenneth G Saag, Michael A Becker, Jeffrey S Borer, Philip B Gorelick, Andrew Whelton, Barbara Hunt, Majin Castillo, Lhanoo Gunawardhana
Background Cardiovascular risk is increased in patients with gout. We compared cardiovascular outcomes associated with febuxostat, a nonpurine xanthine oxidase inhibitor, with those associated with allopurinol, a purine base analogue xanthine oxidase inhibitor, in patients with gout and cardiovascular disease. Methods We conducted a multicenter, double-blind, noninferiority trial involving patients with gout and cardiovascular disease; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function...
March 12, 2018: New England Journal of Medicine
Tsuneo Konta, Keita Kamei, Kazunobu Ichikawa, Takamasa Kayama, Isao Kubota
BACKGROUND: Hyperuricemia is a risk factor for causing end-stage kidney disease and cardiovascular disease in the general population; however, several aspects, such as the site of kidney damaged by hyperuricemia and the threshold levels of serum uric acid for the development of renal damage, have not been fully clarified. SUMMARY: To examine these aspects, we analyzed data from the Takahata study, a community-based cohort study involving participants of an annual health check-up, and used urinary albumin creatinine ratio (UACR) and urinary β2-microglobulin creatinine ratio (UBCR) in spot urine as indices of glomerular and tubular damage respectively...
2018: Contributions to Nephrology
Q H Li, J J Liang, L X Chen, Y Q Mo, X N Wei, D H Zheng, L Dai
Objective: To investigate clinical characteristics and renal uric acid excretion in early-onset gout patients. Methods: Consecutive inpatients with primary gout were recruited between 2013 and 2017. The patients with gout onset younger than 30 were defined as early-onset group while the others were enrolled as control group. Clinical characteristics and uric acid (UA) indicators were compared between two groups. Results: Among 202 recruited patients, the early-onset group included 36 patients (17.8%). Compared with control group, the early-onset group presented more patients with obesity [13 patients (36...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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
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
Rishi J Desai, Jessica M Franklin, Julia Spoendlin-Allen, Daniel H Solomon, Goodarz Danaei, Seoyoung C Kim
OBJECTIVE: Gout patients have a high burden of co-morbid conditions including diabetes mellitus (DM), chronic kidney disease (CKD), and cardiovascular disease (CVD). We sought to evaluate the association between changes in serum uric acid (SUA) levels over time and the risk of incident DM, CVD, and renal function decline in gout patients. METHODS: An observational cohort study was conducted among enrollees of private health insurance programs in the US between 2004 and 2015...
2018: PloS One
Seoyoung C Kim, Tuhina Neogi, Eun Ha Kang, Jun Liu, Rishi J Desai, MaryAnn Zhang, Daniel H Solomon
BACKGROUND: Patients with gout are at an increased risk of cardiovascular (CV) disease including myocardial infarction (MI), stroke, and heart failure (HF). OBJECTIVES: The authors conducted a cohort study to examine comparative CV safety of the 2 gout treatments-probenecid and allopurinol-in patients with gout. METHODS: Among gout patients ≥65 years of age and enrolled in Medicare (2008 to 2013), those who initiated probenecid or allopurinol were identified...
March 6, 2018: Journal of the American College of Cardiology
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
Petter Bjornstad, David M Maahs, Carlos A Roncal, Janet K Snell-Bergeon, Viral N Shah, Tamara Harra, Samuel L Ellis, Matthew Hatch, Linh T Chung, Marian J Rewers, Satish Garg, David Z Cherney, Laura Pyle, Kristen J Nadeau, Richard J Johnson
Uricosuria and crystallization are increasingly recognized risk factors for diabetic tubulopathy. This pilot clinical trial aimed to determine the acute effect of urinary alkalinization using oral sodium bicarbonate [NaHCO3 ] on UA crystals in adults with type 1 diabetes (T1D). Adults with T1D ages 18-65 years (n=45, 60% female, HbA1c 7.5±1.2%, 20.2±9.3 years duration) without chronic kidney disease (eGFR ≥60ml/min/1.73m2 and albumin-to-creatinine ratio <30mg/g) received two doses of 1950 mg oral NaHCO3 over 24 hours...
March 2, 2018: Diabetes, Obesity & Metabolism
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
Antoine Humbert, Fabien Stucker
Uric acid has been known since long ago for its implication in gout and in certain kinds of nephrolithiasis. However, its role in models of acute and chronic nephropathies has been the focus of many new developments. The so called Mesoamerican nephropathy is a devastating disease that has caused more than 20'000 deaths in central America these last few years among sugarcane workers. Acid uric could play a key role in its physiopathology. Moreover, acid uric tends to be recognized as an independent factor of development and progression in chronic kidney disease, opening a way for new therapeutic targets...
February 21, 2018: Revue Médicale Suisse
G Sakalauskienė, G Civinskienė, A Antuševas, P Civinskas
Edematous states caused by an excessesive extracellular fluid retention are major components of cardiovascular and renal disorders including chronic kidney disease, nephrotic syndrome, and heart failure. The use of diuretic drugs from various groups including loop duiretics are important means of pharmacological correction of these clinical conditions. Moreover, diuretics used to lower bood pressure as a part of antihypertensive treatment, reduce cardiovascular events. The response of patients to the dose of a diuretic is reflected by a sigmoid dose-response curve which can be affected by changes of sodium content in the body...
January 2018: Kardiologiia
Stanford E Mwasongwe, Tibor Fülöp, Ronit Katz, Solomon K Musani, Mario Sims, Adolfo Correa, Michael F Flessner, Bessie A Young
Whether elevated uric acid (UA) is an independent risk factor for chronic kidney disease (CKD) is not well established. The authors evaluated the relationship of UA with rapid kidney function decline (RKFD) and incident CKD among 3702 African Americans (AAs) in the Jackson Heart Study with serum UA levels measured at baseline exam (2000-2004). RKFD was defined as ≥ 30% eGFR loss and incident CKD as development of eGFR < 60 mL/min/1.73 m 2 with a ≥ 25% decline in eGFR between baseline and exam 3 (2009-2013)...
February 16, 2018: Journal of Clinical Hypertension
Eliseo Pascual, Francisca Sivera, Mariano Andrés
Hyperuricaemia is an independent risk factor for renal function decline. Evidence is emerging that urate-lowering therapy might be beneficial in subjects with renal impairment. We  review the association between renal impairment and gout, some of the related pathogenic processes and the possible impact of gout treatment on the progression of renal impairment. Nevertheless, the management of gout is more complex in the presence of chronic kidney disease. The main aim of gout therapy is to fully dissolve the urate crystals, thus curing the disease...
February 13, 2018: Drugs & Aging
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
Juan A Tamayo Y Orozco
Systemic implications of hyperuricemia need to be reconsidered in the context of the energy and protein wasting being an early indicator of organ deterioration in patients affected by the cardiometabolic syndrome and other frequent pathology states like pre-eclampsia, hyperparathyroidism, and chronic renal failure. This chapter points out physiological alterations that are to be made related to hyperuricemia, new diagnostic strategies, and early therapeutic interventions in the context of the old enemy: asymptomatic hyperuricemia...
2018: Contributions to Nephrology
Robert Case, Brian Wentworth, Grant Jester
A 33-year-old male with poorly controlled chronic tophaceous gout and chronic kidney disease (CKD) with estimated glomerular filtration rate (GFR) of 37 cc/min. His uric acid was 11 mg/dL despite maximal dosing of febuxostat. He had previously failed pegloticase infusions as well. This patient had a reduction in his uric acid level to less than 6 mg/dL following addition of probenecid to his febuxostat regimen. Most guidelines recommend against utilisation of probenecid therapy in patients with GFR <50, but there is no obvious contraindication to its use, provided renal calculi do not develop...
January 31, 2018: BMJ Case Reports
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
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
Shunya Uchida, Takanori Kumagai, Wen Xiu Chang, Yoshifuru Tamura, Shigeru Shibata
Uric acid (UA) remains a risk factor for the progression of chronic kidney disease (CKD). Most observational studies showed a slight elevation in the serum UA level and this independently predicts the incidence and development of CKD. The recent meta-analysis, however, did not reach the conclusion that urate-lowering therapy with allopurinol retards the progression of CKD. The target level of serum UA if treated is another issue of debate. Our recent analysis by propensity score analysis has shown that the serum UA should be targeted below 6...
2018: Contributions to Nephrology
2018-02-04 23:16:07
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