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Uric Acid and Kidney

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Naina Kumar, Amit K Singh
OBJECTIVE: Assess the relationship between maternal serum uric acid and severity of Hypertensive disorders of pregnancy in a rural tertiary care centre. MATERIALS AND METHODS: Present study was conducted in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India over seven months (October 2016-May 2017) on 110 women admitted with a Hypertensive disorder of pregnancy (Gestational hypertension, Pre-eclampsia, Eclampsia) at ≥34 weeks gestation...
November 12, 2018: Current Hypertension Reviews
Philip C Robinson
Gout is an increasingly common chronic disorder of urate crystal deposition that manifests as flares of acute inflammatory arthritis. Hyperuricaemia is a prerequisite and a fifth of both men and woman are hyperuricaemic. The prevalence of gout is much lower than the prevalence of hyperuricaemia for reasons that are not currently clear. Gout is more common in men than women prior to menopause due to the uricosuric effects of oestrogen, but after menopause the incidence of gout rises substantially in women. Co-morbidities are an important issue in gout, with cardiovascular disease, diabetes mellitus, obesity and chronic kidney disease all common in patients with gout...
December 2018: Maturitas
Kuan-Ju Lai, Chew-Teng Kor, Yao-Peng Hsieh
Background: The results have been inconsistent with regards to the impact of uric acid (UA) on clinical outcomes both in the general population and in patients with chronic kidney disease. The aim of this study was to study the influence of serum UA levels on mortality in patients undergoing continuous ambulatory peritoneal dialysis. Methods: Data on 492 patients from a single peritoneal dialysis unit were retrospectively analyzed. The mean age of the patients was 53.5 ± 15.3 years, with 52% being female ( n = 255)...
November 5, 2018: Journal of Clinical Medicine
Milan Khadka, Binod Pantha, Lochan Karki
INTRODUCTION: Chronic Kidney Disease is a worldwide public health problem that affects millions of people from all racial and ethnic groups. Identification of a Chronic Kidney Disease is a major risk factor for cardiovascular morbidity and mortality and is attributed to hyperuricemia. Evidences show that high serum uric acid contribute directly to glomerulosclerosis, interstitial fibrosis and atherosclerosis that correction of hyperuricemia associated with Chronic Kidney Disease will slow the progression of chronic renal failure...
July 2018: JNMA; Journal of the Nepal Medical Association
Partha Saradhi Sarvepalli, Mehruq Fatima, Abdul Khalid Quadri, Aliya Raeesa Taher, Ayesha Habeeb, Fayeza Amreen, Badarunnisa Nikhat Parveen, K G Rajaram
Hyperuricemia [serum uric acid (SUA) >7.0 mg/dL] which is common in chronic renal diseases is associated with augmented vascular events. In addition to nonpharmacological therapy, hypouricosuric drugs reduce UA levels. The current study was a prospective observational study of six months duration November 2016 to April 2017 done to determine the efficacy of febuxostat in patients with hyperuricemia in chronic kidney disease (CKD) stage G3a to G5 and to correlate any association with reduction of hypertension, improvement in glomerular filtration rate (GFR), and reduction in comorbidities...
September 2018: Saudi Journal of Kidney Diseases and Transplantation
Ze Wang, Tao Cui, Xiaoyan Ci, Fang Zhao, Yinghui Sun, Yazhuo Li, Rui Liu, Weidang Wu, Xiulin Yi, Changxiao Liu
The abnormal metabolism of uric acid results in many disease such as chronic kidney disease, hyperuricemia, nephrolithiasis, gout, hypertension, vascular disease and so on. Serum uric acid levels are maintained by the balance between production and elimination. There are many factors that maintain the balance of serum uric acid. One of them is transporters which are responsible for the debouchment of uric acid within blood. The transport and excretion of uric acid is a complicated procedure which is related with various transporters such as OAT1, OAT3, OAT4, URAT1, GLUT9, BCRP, MRP4, NPT1, NTP4, and so on...
October 31, 2018: Journal of Nephrology
Camilla Olofsson, Björn Anderstam, Ann-Christin Bragfors-Helin, Monica Eriksson, Abdul Rashid Qureshi, Bengt Lindholm, Agneta Hilding, Wieslaw Wiczkowski, Nicola Orsini, Peter Stenvinkel, Neda Rajamand Ekberg
BACKGROUND: Fructose intake may lead to hyperuricaemia, which is associated with increased risk and progression of kidney disease. We aimed to explore the acute effects of fructose loading from different sources, with and without a pizza, on levels of serum uric acid in patients with chronic kidney disease (CKD), type 2 diabetes (T2D) without CKD, and in healthy subjects (HS). METHODS: The study included 6 HS, and 3 CKD stage 4-5 and 7 T2D patients. Drinks consumed were blueberry drink (17...
October 28, 2018: European Journal of Clinical Investigation
Emily S Andrews, Loni Perrenoud, Kristen L Nowak, Zhiying You, Andreas Pasch, Michel Chonchol, Jessica Kendrick, Diana Jalal
BACKGROUND: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a systemic disorder that leads to vascular calcification and accelerated atherosclerosis. Uric acid has been shown to associate with vascular calcification and with carotid intima-media thickness (CIMT) and to suppress the 1 α-hydroxylase enzyme leading to lower 1,25-dihydroxyvitamin D (1,25(OH)2D) and higher intact parathyroid hormone (iPTH) levels. We hypothesized that lowering serum uric acid would reduce CIMT, calcification propensity, and circulating markers of CKD-MBD in CKD...
2018: PloS One
Michael Doherty, Wendy Jenkins, Helen Richardson, Aliya Sarmanova, Abhishek Abhishek, Deborah Ashton, Christine Barclay, Sally Doherty, Lelia Duley, Rachael Hatton, Frances Rees, Matthew Stevenson, Weiya Zhang
BACKGROUND: In the UK, gout management is suboptimum, with only 40% of patients receiving urate-lowering therapy, usually without titration to achieve a target serum urate concentration. Nurses successfully manage many diseases in primary care. We compared nurse-led gout care to usual care led by general practitioners (GPs) for people in the community. METHODS: Research nurses were trained in best practice management of gout, including providing individualised information and engaging patients in shared decision making...
October 20, 2018: Lancet
Azhar Hussain, Omar B Latiwesh, Farwa Ali, Mustafa Y G Younis, Jamal A Alammari
Background Plasma uric acid has been shown to be associated with an increased risk of hypertension, cardiovascular disease, chronic kidney disease, insulin resistance, and metabolic syndrome. Conflicting data regarding plasma uric acid levels in type 2 diabetes mellitus and their role in the development and progression of diabetic complications have been observed by many studies. The present study aimed to evaluate plasma uric acid levels in type 2 diabetic patients and to determine the effects of hypoglycemic drugs and pharmacologic insulin on plasma uric acid concentration...
August 17, 2018: Curēus
William B White, Lhanoo Gunawardhana
New England Journal of Medicine, Volume 379, Issue 16, Page 1582-1584, October 2018.
October 18, 2018: New England Journal of Medicine
Tanya J Major, Ruth K Topless, Nicola Dalbeth, Tony R Merriman
OBJECTIVE: To systematically test dietary components for association with serum urate levels and to evaluate the relative contributions of estimates of diet pattern and inherited genetic variants to population variance in serum urate levels. DESIGN: Meta-analysis of cross sectional data from the United States. DATA SOURCES: Five cohort studies. REVIEW METHODS: 16 760 individuals of European ancestry (8414 men and 8346 women) from the US were included in analyses...
October 10, 2018: BMJ: British Medical Journal
Ana Beatriz Vargas-Santos, Christine E Peloquin, Yuqing Zhang, Tuhina Neogi
Importance: Clinicians are often cautious about use of allopurinol in patients with gout when renal function declines. Objective: To assess the association of allopurinol use in gout with the risk of developing chronic kidney disease stage 3 or higher. Design, Setting, and Participants: A time-stratified propensity score-matched, population-based, prospective cohort study of individuals with newly diagnosed gout who initiated allopurinol (≥300 mg/d) compared with those who did not initiate allopurinol, using the Health Improvement Network (THIN), a United Kingdom general practitioner electronic health records database, was carried out...
November 1, 2018: JAMA Internal Medicine
Farideh Razi, Ensieh Nasli-Esfahani, Fatemeh Bandarian
Background: Diabetic nephropathy (DN) is the major cause of end-stage renal disease. Recent studies suggest that it is probable that uric acid is involved in the pathogenesis of diabetic nephropathy. This study aim was to investigate the association between serum uric acid and kidney function in Iranian patients with type 2 diabetes mellitus. Methods: In this case-control study, a total of 201 diabetic patients with or without impaired kidney function (glomerular filtration rate/GFR < 60 and GFR ≥ 60) were selected...
June 2018: Journal of Diabetes and Metabolic Disorders
Xuemei Liu, Huifang Wang, Ruixia Ma, Leping Shao, Wei Zhang, Wei Jiang, Congjuan Luo, Tingting Zhai, Yan Xu
BACKGROUND: While the dose of allopurinol is limited in patients with chronic kidney disease (CKD), information is lacking concerning the efficacy, safety, and maintenance dose of febuxostat in Chinese patients with hyperuricemia and with CKD stages 3-5. METHODS: A single center, prospective cohort study was conducted in patients with CKD stages 3-5 and with hyperuricemia who had not yet begun to undergo renal replacement therapy. We enrolled 208 patients who were newly treated with febuxostat (n = 112) or allopurinol (n = 96) in this study...
October 5, 2018: Clinical and Experimental Nephrology
Kwang Ho Mun, Gyeong Im Yu, Bo Youl Choi, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin
OBJECTIVES: Several studies have investigated the effects of serum uric acid (SUA) levels on chronic kidney disease (CKD), with discrepant results. The effect of SUA levels on CKD development was studied in the Korean rural population. METHODS: A total of 9695 participants aged ≥40 years were recruited from 3 rural communities in Korea between 2005 and 2009. Of those participants, 5577 who participated in the follow-up and did not have cerebrovascular disease, myocardial infarction, cancer, or CKD at baseline were studied...
September 2018: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
Sabrina Mai Nielsen, Kristian Zobbe, Lars Erik Kristensen, Robin Christensen
OBJECTIVE: To present the evidence for nutritional lifestyle changes recommended for gout patients; an explicit focus will be on the evidence for weight loss in overweight gout patients based on a recent systematic review and to describe methodological details for an upcoming weight loss trial. METHODS: We did a pragmatic but systematic search in MEDLINE for current guidelines that had made an attempt to make nutritional recommendations for gout. The quality of the evidence for the nutritional recommendations was evaluated based on the guidelines' own ratings and converted into a common simple version based on the GRADE system...
November 2018: Autoimmunity Reviews
Daniel H Solomon, Robert J Glynn, Jean G MacFadyen, Peter Libby, Tom Thuren, Brendan M Everett, Paul M Ridker
Background: Although studies have shown that interleukin-1β (IL-1β) inhibitors can shorten gout attacks, whether they can prevent gout attacks is unclear. Objective: To examine the relationship among canakinumab, a monoclonal antibody targeting IL-1β; serum uric acid levels; and the incidence of gout attacks. Design: Secondary exploratory analysis of a randomized controlled trial. ( NCT01327846). Setting: Many clinical sites in 39 countries...
October 16, 2018: Annals of Internal Medicine
Gerald Levy, Jiaxiao M Shi, T Craig Cheetham, Nazia Rashid
CONTEXT: Hyperuricemia is an independent risk factor for progression of kidney disease. OBJECTIVE: To determine whether lowering serum uric acid level (sUA) to below 6 mg/dL (target) improves mild to moderate chronic kidney disease (CKD) and whether CKD stage influences the benefit of lowering sUA to target. DESIGN: Retrospective epidemiologic cohort study conducted over 8 years. Estimated glomerular filtration rate (eGFR) was required in the 6 months preceding the index date (defined as first occurrence of sUA < 7 mg/dL), and at least 1 sUA and eGFR were required during follow-up...
August 30, 2018: Permanente Journal
Minning Shen, Junyu Zhang, Kai Qian, Chunmei Li, Wenyu Xu, Bingjie Gu, Xiaoqin Wang, Qijie Ren, Leilei Yang, Hai Yuan, Dinglei Su, Xingguo Chen
To retrospectively analyze the efficacy and safety of febuxostat on gout patients with low serum uric acid level. A study was conducted in Nanjing First Hospital from October 2015 to September 2016. Thirty nine acute gouty arthritis patients from the emergency and outpatient department were included. Patients met the 2015 Gout Classification Criteria revised by American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) and had urate deposition around the joints detected by dual-energy computerized tomography (DECT)...
November 2018: Clinical Rheumatology
2018-09-11 11:16:42
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