Uric Acid: The Unknown Uremic Toxin

Treviño–Becerra, Alejandro

doi:10.1159/000484275

Cited by 19 publications

(10 citation statements)

References 25 publications

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“…The association between uric acid levels and damage accrual in patients with SLE was evaluated, and serum uric acid level was found to be associated with the development of new damage in these patients. Previous studies have found an association between hyperuricaemia and hypertension,13 metabolic syndrome14 and renal disease,2 as well as with organ failure or damage,15 especially renal 16…”

Section: Discussionmentioning

confidence: 99%

“…The solubility of uric acid at normal physiological pH is generally given at 6.8 mg/dL, with reference ranges for uric acid of 3.5–7.2 mg/dL (210–430 µmol/L) and 2.6–6.0 mg/dL (155–360 µmol/L) in younger men and premenopausal women, respectively 1. Hyperuricaemia is the result of increased production or decreased excretion of uric acid 2. Uric acid levels have been associated with increased risk of heart mortality,3 increased risk of kidney disease4 and as a predictor of metabolic syndrome 5…”

Section: Introductionmentioning

confidence: 99%

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Serum uric acid is associated with damage in patients with systemic lupus erythematosus

et al. 2020

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IntroductionSerum uric acid levels have been reported as predictors of cardiovascular, pulmonary, neurological and renal morbidity in patients with SLE. However, their role in cumulative global damage in these patients has not yet been determined.ObjectiveTo determine whether serum uric acid levels are associated with new damage in patients with SLE.MethodsThis is a longitudinal study of patients with SLE from the Almenara Lupus Cohort, which began in 2012. At each visit, demographic and clinical characteristics were evaluated, such as activity (Systemic Lupus Erythematosus Disease Activity Index-2K or SLEDAI-2K) and cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index or SDI). Treatment (glucocorticoids, immunosuppressive drugs and antimalarials) was also recorded. Univariable and multivariable Cox regression models were used to determine the impact of serum uric acid levels on the risk of new damage.ResultsWe evaluated 237 patients, with a mean age (SD) at diagnosis of 35.9 (13.1) years; 220 patients (92.8%) were women, and the duration of the disease was 7.3 (6.6) years. The mean SLEDAI-2K and SDI scores were 5.1 (4.2) and 0.9 (1.3), respectively. Serum uric acid level was 4.5 (1.4) mg/dL. Follow-up time was 3.1 (1.3) years, and 112 (47.3%) patients accrued damage during follow-up. In univariable and multivariable analyses, serum uric acid levels were associated with new damage (HR=1.141 (95% CI 1.016 to 1.282), p=0.026; HR=1.189 (95% CI 1.025 to 1.378), p=0.022, respectively).ConclusionHigher serum uric acid levels are associated with global damage in patients with SLE.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

et al. 2020

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“…Hyperuricemia has been found to independently predict the development of diabetes and mediate insulin resistance in both fructose-dependent and fructose-independent models of metabolic syndrome. 33 Abnormal total cholesterol level is a risk factor for occurrence of sight-threatening DR and diabetic macular edema, and higher serum triglyceride level is a risk factor for PDR in subjects with type 2 diabetes. Dyslipidemia with abnormal levels of total cholesterol, LDL, HDL, and triglyceride is associated with greater risk of incident diabetic macular edema and greater risk for progression to PDR, compared with abnormal levels of individual lipid levels.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Progression of Diabetic Retinopathy in Eyes Treated With Panretinal Photocoagulation

Baek

Park

Cho

et al. 2021

Preprint

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Uncontrolled diabetes has been associated with progression of diabetic retinopathy (DR) in several studies. Therefore, we aimed to investigate systemic and ophthalmic factors related to worsening of DR even after completion of panretinal photocoagulation (PRP). DR patients who had completed PRP in at least one eye with a 3-year follow-up after PRP were included. A total of 243 eyes of 243 subjects (mean age 52.6±11.6 years) were enrolled. Among them, 52 patients (21.4%) showed progression of DR after PRP (progression group), and the other 191 (78.6%) patients had stable DR (non-progression group). The progression group had higher proportion of proliferative DR (P=0.019); lower baseline visual acuity (P<0.001); and higher platelet count (P=0.048), hemoglobin (P=0.044), and hematocrit, (P=0.042) than the non-progression group. In the multivariate logistic regression analysis for progression of DR, baseline visual acuity (HR: 0.053, P<0.001) and platelet count (HR: 1.215, P=0.031) were identified as risk factors for progression. Consequently, we propose that patients with low visual acuity or high platelet count are more likely to have progressive DR despite PRP and require careful observation. Also, the evaluation of hemorheological factors including platelet counts before PRP can be considered useful in predicting the prognosis of DR.

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“…A large number of studies have been carried out to investigate the effects of ULT on CKD progression (reviewed in [42,57,58]). While many trials have reported that ULT has a benefit on renal outcomes, others found that ULT provided no benefit [59].…”

Section: Role Of Urate-lowering Therapy In Prevention Of Ckdmentioning

confidence: 99%

Management of Hyperuricemia in Patients with Chronic Kidney Disease: a Focus on Renal Protection

2020

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Purpose of Review In chronic kidney disease (CKD), plasma uric acid levels are increased because of the decrease in glomerular filtration rate. However, in addition to CKD, hyperuricemia is frequently associated with a number of other conditions such as hypertension, type 2 diabetes, obesity, and heart failure, overweight, and cardiovascular disease. Recent Findings It is now becoming increasingly clear that, in many clinical conditions, elevated levels of uric acid have a much greater role beyond just causing gout. The present review will summarize current knowledge on the relation between hyperuricemia, CKD, and existing comorbidities, as well as the mechanisms of uric acid–related renal damage. In addition, the role and evidence for urate-lowering therapy in prevention and cardiovascular protection in CKD patients is discussed with a focus on allopurinol and febuxostat. To date, several clinical studies have provided evidence that urate-lowering therapy may help to prevent and delay the decline of renal function in patients with CKD. Summary Use of a xanthine oxidase inhibitor should be considered in patients who are at high renal risk and/or with declining renal function in the presence of hyperuricemia with and without deposition, although additional studies are warranted to define treatment targets. Notwithstanding, the possibility to delay deterioration of renal function in patients with CKD merits consideration.

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Uric Acid: The Unknown Uremic Toxin

Cited by 19 publications

References 25 publications

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

Risk Factors Associated With Progression of Diabetic Retinopathy in Eyes Treated With Panretinal Photocoagulation

Management of Hyperuricemia in Patients with Chronic Kidney Disease: a Focus on Renal Protection

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