Aim The role of serum uric acid in ischemic stroke is controversial. On the one hand, it has a role as neuroprotectant in acute phase, but on the other hand, it may promote atherosclerosis in carotid arteries. Our aim is to investigate the association of serum uric acid levels at admission of acute ischemic stroke patients with carotid disease. Methods Cross-sectional study of patients admitted due to acute ischemic stroke. Clinical and laboratory variables were recorded. The carotid disease was defined based on the findings of carotid echography intima to media thickness and stenosis. Patients were grouped according to these findings. Robust statistical methods were applied into analysis. Results A total of 245 patients were recruited through a stroke registry. Their values of serum uric acid were related to both carotid intima to media thickness and stenosis showing a positive relationship between serum uric acid levels and intima to media thickness by Pearson correlation ( p < 0.05). Similarly, after adjusting for all potential confounders, eGFR, glucose, age and serum uric acid levels, (OR 1.26 (95% CI 1.04 -1.52, p¼0.01), were identified as independent predictors for having a intima to media thickness ≥1 mm. Similarly, by grouping patients in tertiles of the serum uric acid distribution, we found a predominantly greater carotid disease in the tertile with the highest levels of serum uric acid ( p < 0.005). Conclusion Our study supports the hypotheses that serum uric acid levels have different roles in the case of ischemic stroke. Its effects on the vascular wall contribute to the development of atherosclerosis and carotid disease.
Esta obra presenta un compendio resumido, claro y conciso, útil para los médicos no especializados en la materia, así como para los estudiantes en su formación de pregrado, sobre las patologías que afectan a los riñones, vías urinarias y aparato genital masculino para el ejercicio médico, puesto que, en lo que no corresponde a nuestra especialización, todos somos médicos generales. Esta obra aborda la Nefrología, la Urología y la Andrología con una concepción actual integradora e interdisciplinar, escrita por especialistas del campo de la Nefrología, la Urología y la Medicina de Familia. Todos ellos atienden diariamente enfermos y por ello han logrado verter en cada uno de los capítulos su proceder clínico habitual y la forma real de abordarlas junto a las actualizaciones de estos temas. Los editores de este manual somos profesores de la asignatura de Nefrología y de Urología en la Facultad de Medicina de Salamanca y en nuestra experiencia asistencial y docente hemos decidido elaborar este manual que se ciñe y glosa el contenido de la Nefrourología.
The HUGE formula allows the prediction of CKD in the general population to be honed without relying on serum creatinine levels. This method was found to have a higher specificity than the MDRD-4 formula. Moreover, it could reduce the excessively extensive diagnostic suspicion of CKD in women.
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