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Uric Acid and Kidney

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Xinrui Li, Jing Liu, Liang Ma, Ping Fu
Chronic kidney disease (CKD) has become a global public health issue and uric acid (UA) remains a major risk factor of CKD. As the main organ for the elimination of UA, kidney owned a group of urate transporters in tubular epithelium. Kidney disease hampered the UA excretion, and the accumulation of serum UA in return harmed the renal function. Commercially, there are three kinds of agents targeting at urate-lowering, xanthine oxidoreductase inhibitor which prevents the production of UA, uricosuric which increases the concentration of UA in urine thus decreasing serum UA level, and uricase which converts UA to allantoin resulting in the dramatic decrement of serum UA...
January 23, 2019: European Journal of Medicinal Chemistry
Yuliya Lytvyn, Petter Bjornstad, Julie A Lovshin, Sunita K Singh, Genevieve Boulet, Mohammed A Farooqi, Vesta Lai, Josephine Tse, Leslie Cham, Leif E Lovblom, Alanna Weisman, Hillary A Keenan, Michael H Brent, Narinder Paul, Vera Bril, Andrew Advani, Etienne Sochett, Bruce A Perkins, David Z I Cherney
AIMS: Higher plasma uric acid (PUA) concentrations are associated with renal vasoconstriction, renin angiotensin aldosterone system (RAAS) activation and vascular stiffness, however the timeline for these associations in type 1 diabetes (T1D) is not clear. We aimed to compare the changes in such associations over a wide range of T1D duration. MATERIALS AND METHODS: PUA, glomerular filtration rate (GFRINULIN ), effective renal plasma flow (ERPFPAH ), vascular stiffness parameters (aortic augmentation index [AIx], carotid AIx, carotid femoral pulse wave velocity [cfPWV]), plasma renin and aldosterone were measured during a euglycemic clamp in participants with T1D: 27 adolescents (age 16...
February 13, 2019: Diabetes, Obesity & Metabolism
Clifford J Bailey
Sodium/glucose co-transporter-2 (SGLT2) inhibitors, which lower blood glucose by increasing renal glucose elimination have been shown to reduce the risk of adverse cardiovascular (CV) and renal events in type 2 diabetes. This has been ascribed in part to haemodynamic changes, body weight reduction and several possible effects on myocardial, endothelial and tubulo-glomerular functions as well as reduced glucotoxicity. This review evaluates evidence that an effect of SGLT2 inhibitors to lower uric acid may also contribute to reduced cardio-renal risk...
February 14, 2019: Diabetes, Obesity & Metabolism
Fangfang Zhou, Geping Yu, Guoyu Wang, Yunzi Liu, Liwen Zhang, Weiming Wang, Nan Chen
BACKGROUND: Epidemiological studies suggest that higher serum uric acid (SUA) level is significantly associated with kidney disease development. However, it remains debatable whether higher SUA is independently associated with new-onset kidney disease and rapid eGFR decline in individuals with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and negative proteinuria. METHODS: This was a large, single-center, retrospective 6-year cohort study at People's Hospital of Tonglu County, Zhejiang, from 2001 to 2006...
February 8, 2019: Clinical and Experimental Nephrology
Jung Sun Lee, Oh Chan Kwon, Ji Seon Oh, Yong-Gil Kim, Chang-Keun Lee, Bin Yoo, Seokchan Hong
Background/Aims: A substantial portion of gout patients have normal serum urate levels during an acute attack but data on the clinical characteristics and risk of recurrence compared with hyperuricemic patients are limited. Methods: In this retrospective cohort study, clinical features of normouricemic and hyperuricemic patients were compared. Multivariate analysis was performed to determine whether normouricemic patients were less likely to have a recurrent attack...
January 28, 2019: Korean Journal of Internal Medicine
Elshaeima Mohammed, Leonard D Browne, Arun Kumar A U, Fahd Adeeb, Alexander D Fraser, Austin G Stack
BACKGROUND: Gout is a common inflammatory arthritis associated with adverse clinical outcomes. Under treatment is common in the general population. The aim of this study was to determine the prevalence of gout and its treatment among patients with chronic kidney disease (CKD). METHODS: We conducted a multi-centre cross sectional study of patients (n = 522) who attended specialist nephrology clinics in Ireland. Standardized data collection tool recorded clinical characteristics and medication use at clinic visits and kidney function was assessed with standardised creatinine measurements and Estimated Glomerular Filtration Rate (eGFR)...
2019: PloS One
Min Tao, Yingfeng Shi, Lunxian Tang, Yi Wang, Lu Fang, Wei Jiang, Tao Lin, Andong Qiu, Shougang Zhuang, Na Liu
Extracellular signal-regulated kinases 1 and 2 (ERK1/2) are serine/threonine kinases and function as regulators of cellular proliferation and differentiation. Recently, we demonstrated that inhibition of ERK1/2 alleviates the development and progression of hyperuricemia nephropathy (HN). However, its potential roles in uric acid-induced tubular epithelial-mesenchymal transition (EMT) and tubular epithelial cell injury are unknown. In this study, we showed that hyperuricemic injury induced EMT as characterized by down-regulation of E-cadherin and up-regulation of Vimentin and Snail1 in a rat model of HN...
January 16, 2019: American Journal of Physiology. Renal Physiology
T Aatif, J Fatihi, H El Annaz, O Qamouss
Allopurinol-induced drug reactions with eosinophilia and systemic symptoms (DRESS) is a severe illness related to hypersensitivity syndrome characterized by fever, skin rash, lymph node enlargement, hematological abnormalities, especially eosinophilia and atypical lymphocytosis, and single or multiple organ involvement. The syndrome is difficult to diagnose in view of its clinical heterogeneity and long latency period within 8 weeks after start treatment. We report a case of DRESS syndrome in a 64-year-old man, induced by allopurinol treatment for asymptomatic hyperuricemia, started 8 weeks earlier but stopped only 3 days after because of the onset of rash...
November 2018: Indian Journal of Nephrology
Daniel M Jordan, Hyon K Choi, Marie Verbanck, Ruth Topless, Hong-Hee Won, Girish Nadkarni, Tony R Merriman, Ron Do
BACKGROUND: Studies have shown strong positive associations between serum urate (SU) levels and chronic kidney disease (CKD) risk; however, whether the relation is causal remains uncertain. We evaluate whether genetic data are consistent with a causal impact of SU level on the risk of CKD and estimated glomerular filtration rate (eGFR). METHODS AND FINDINGS: We used Mendelian randomization (MR) methods to evaluate the presence of a causal effect. We used aggregated genome-wide association data (N = 110,347 for SU, N = 69,374 for gout, N = 133,413 for eGFR, N = 117,165 for CKD), electronic-medical-record-linked UK Biobank data (N = 335,212), and population-based cohorts (N = 13,425), all in individuals of European ancestry, for SU levels and CKD...
January 2019: PLoS Medicine
Min Woo Kang, Ho Jun Chin, Kwon-Wook Joo, Ki Young Na, Sejoong Kim, Seung Seok Han
BACKGROUND: Hyperuricemia is a risk factor for high morbidity and mortality in several diseases. However, the relationship between uric acid and the risk of acute kidney injury (AKI) and mortality remains unresolved in hospitalized patients. METHODS: Data from 18,444 hospitalized patients were retrospectively reviewed. The odds ratio (OR) for AKI and the hazard ratio (HR) for all-cause mortality were calculated based on the uric acid quartiles after adjustment for multiple variables...
January 15, 2019: Nephrology
Qimei Luo, Xi Xia, Bin Li, Zhenchuan Lin, Xueqing Yu, Fengxian Huang
BACKGROUND: Conflicting results have been reported from studies evaluating serum uric acid (SUA) levels as an independent risk factor for cardiovascular mortality in patients with chronic kidney disease (CKD). METHODS: We systematically searched MEDLINE, Web of Science, and bibliographies of retrieved articles to identify studies reporting on the association between SUA levels and cardiovascular mortality in patients with CKD. Random-effects models were used to calculate the pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI)...
January 14, 2019: BMC Nephrology
Robert M Centor, Angelo L Gaffo
No abstract text is available yet for this article.
January 15, 2019: Annals of Internal Medicine
Jang-Wook Lee, Kwang-Hoon Lee
PURPOSE: This study aimed to compare the renoprotective effect between febuxostat and allopurinol in hyperuricemic patients with chronic kidney disease (CKD), about which limited data are available. METHODS: 141 patients with stage 3 CKD and hyperuricemia were followed from June 2005 to April 2018. Thirty patients received febuxostat, 40 allopurinol and 71 conventional CKD management only (control group). We compared the mean serum uric acid levels, estimated glomerular filtration rate (eGFR) changes over time and renal survival time free from predefined renal disease progression among these 3 groups...
January 2, 2019: International Urology and Nephrology
Xiaoju Shen, Jingjie Li, Qian Fu, Longshan Liu, Xiang Gao, Xiao Chen, Pan Chen, Changxi Wang
WHAT IS KNOWN AND OBJECTIVE: Febuxostat and allopurinol are xanthine oxidase inhibitors for urate-lowering therapy. The efficacy and safety of febuxostat and allopurinol have been mostly reported in hyperuricemia patients with normal renal function. Here, we aimed to compare the effects of these two drugs in early post-renal transplant recipients, focusing on evaluating the urate-lowering effect and recovery of allograft renal function. METHODS: A retrospective cohort study was performed in early post-renal transplant recipients with new onset of hyperuricemia receiving febuxostat or allopurinol therapy...
December 23, 2018: Journal of Clinical Pharmacy and Therapeutics
Risa B Burns, C Christopher Smith, Robert H Shmerling, Anjala Tess
Gout is the most common form of inflammatory arthritis. In 2012, the American College of Rheumatology (ACR) issued a guideline, which was followed in 2017 by one from the American College of Physicians (ACP). The guidelines agree on treating acute gout with a corticosteroid, nonsteroidal anti-inflammatory drug, or colchicine and on not initiating long-term urate-lowering therapy (ULT) for most patients after a first gout attack and in those whose attacks are infrequent (<2 per year). However, they differ on treatment of both recurrent gout and problematic gout...
December 4, 2018: Annals of Internal Medicine
Z Biyik, I Guney
This study aimed to determine the association of atherogenic index of plasma (AIP) with both hyperuricemia and proteinuria in renal transplant recipients. MATERIAL AND METHODS: Between the years 2015 and 2017, 61 renal transplant recipients with at least 1 year of follow-up were included in this retrospective cohort study. Uric acid levels of ≥7 mg/dL in men and ≥6 mg/dL in women were accepted as hyperuricemia. The patients were separated into groups according to their serum uric acid and AIP levels...
May 29, 2018: Transplantation Proceedings
Jianmin Ran, Gang Xu, Huixuan Ma, Hailing Xu, Yan Liu, Rongshao Tan, Ping Zhu, Jun Song, Gancheng Lao
Aim . In this study, we aimed to investigate the effects of febuxostat, a novel inhibitor of xanthine oxidase (XO), on renal damage in streptozotocin- (STZ-) induced diabetic rats. Methods . Diabetes was induced by the intraperitoneal injection of STZ in male Sprague-Dawley rats. Sham-injected rats served as controls. The control and diabetic rats were treated with and without febuxostat for 8 weeks, respectively. Fasting blood and 24-h urine samples were collected every 4 weeks. Rat livers were extracted for detecting gene expression, content, and bioactivity of XO...
2017: International Journal of Nephrology
Miguel Ángel Gómez-Sámano, Paloma Almeda-Valdes, Daniel Cuevas-Ramos, María Fernanda Navarro-Flores, Héctor Donaldo Espinosa-Salazar, Mayela Martínez-Saavedra, Jefsi Argelia León-Domínguez, Víctor Manuel Enríquez-Estrada, Ana Laura López-González, Ana Laura Sarmiento-Moreno, Lucero Alejandra Rivera-González, Óscar Alfredo Juárez-León, Bernardo Pérez-González, Yessica Ávila-Palacios, Lineth Sigala-Pedroza, Eira Huerta-Ávila, María Angelina Vargas-Álvarez, Carlos Sánchez-Jaimes, Mariana Cárdenas-Vera, Roopa Mehta, Manuel Alejandro López-Flores A La Torre, Iliana Manjarrez-Martínez, Griselda Xochitl Brito-Córdova, Julia M Zuarth-Vázquez, Arturo Vega-Beyhart, Guadalupe López-Carrasco, Richard J Johnson, Francisco Javier Gómez-Pérez
The aim of this single center cross-sectional study was to investigate the association between fructose intake and albuminuria in subjects with type 2 diabetes mellitus (T2DM). This is a single center cross-sectional study. One hundred and forty-three subjects with T2DM were recruited from the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran. The median daily fructose intake was estimated with a prospective food registry during 3 days (2 week-days and one weekend day) and they were divided into low fructose intake (<25 g/day) and high fructose intake (≥ 25 g/day)...
2018: International Journal of Nephrology
Yong-Yao Wu, Xiao-Hui Qiu, Yun Ye, Chao Gao, Fuquan Wu, Guihua Xia
OBJECTIVE: Uric acid (UA) is a risk marker of CKD and SUA level in CKD 3-4 patients closely correlates with hyperuricemic nephropathy (HN) morbidity. This study was designed to evaluate the risk factors for HN in CKD 3-4 patients. METHODS: The 461 CKD 3-4 patients were recruited and all patients were divided into three groups (24 h UUA normal, underexeret, and overproduct type groups) according to the 24 h UUA level after receiving low purine food for five days...
November 2018: Renal Failure
Davide Viggiano, Giuseppe Gigliotti, Gianfranco Vallone, Anna Giammarino, Michelangelo Nigro, Giovambattista Capasso
Current urate-lowering therapy (ULT) includes three direct acting drugs (allopurinol, febuxostat, Rasburicase) and at least four 'indirect' drugs with other important targets (canagliflozin, losartan, fenofibrate and sevelamer). Moreover, the alcalinization of urines using bicarbonate can be used to dissolve urate crystals and the clinician may discontinue several drugs are known to increase serum levels of uric acid, such as diuretics, aspirin, cyclosporine, theophylline, mycophenolate and ACE inhibitors. While there is a consensus to start ULT in cases of symptomatic hyperuricemia (gout, urate-nephrolithiasis), the very frequent conditions of asymptomatic hyperuricemia remains a major conundrum...
2018: Kidney & Blood Pressure Research
2018-11-29 10:16:09
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