A multicenter study of the association of serum uric acid, serum creatinine, and diuretic use in hypertensive patients

Lin, Chiu‐Chu; Hung, Yi‐Jen; Chen, Gau-Yang; Tzeng, Thing-Fong; Lee, Du-Yi; Chen, Cheng-Yun; Huang, Wen-Pin; Huang, Chin-Hsung

doi:10.1016/j.ijcard.2009.11.024

Cited by 26 publications

(21 citation statements)

References 26 publications

(27 reference statements)

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“…21 Similar results were obtained in the present study, in which the serum uric acid level was significantly associated with these clinical conditions. The contradictory association between uric acid and cardiovascular risk factors, however, might be possible because serum uric acid level is, at least in part, passively increased by the existence of various cardiovascular risk factors.…”

Section: Suzuki S Et Alsupporting

confidence: 91%

Gender-Specific Relationship Between Serum Uric Acid Level and Atrial Fibrillation Prevalence

Suzuki

Sagara

Otsuka

et al. 2012

Circ J

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Section: Suzuki S Et Alsupporting

confidence: 91%

Gender-Specific Relationship Between Serum Uric Acid Level and Atrial Fibrillation Prevalence

Suzuki

Sagara

Otsuka

et al. 2012

Circ J

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“…Although diuretics use may associate with increased serum uric acid level, the association between diuretic use and eGFR decline is controversial [26]. Therefore, our study results should be robust with and without adjusting for the usage of diuretics [60]. Fourth, the etiologies of hyperuricemia were not determined systematically in this study.…”

Section: Discussionmentioning

confidence: 91%

Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review

Tsai¹,

Lin²,

Kuo³

et al. 2017

PLoS ONE

145

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BackgroundIncreasing evidence supports the association between hyperuricemia and incident chronic kidney disease (CKD); however, there are conflicting data regarding the role of hyperuricemia in the progression of CKD. This study retrospectively assessed the longitudinal association between uric acid (UA) level and CKD progression in a Chinese population lived in Taiwan.MethodsPatients with physician diagnosis of hyperuricemia or receiving urate-lowering therapy between 2003 and 2005 were identified in the electronic medical records (EMR) of a tertiary medical center and were followed up until December 31, 2011. Patients were divided into four UA categories at the cut-off 6, 8, and 10 mg/dL. CKD progression was estimated by the change of estimated glomerular filtration rate (eGFR) in the linear mixed models. Kidney failure was defined as an eGFR less than 15 mL/min/1.73 m2 or requiring renal replacement therapy.ResultsA total of 739 patients were analyzed. In the full-adjusted model, patients with a baseline UA level ≥6 mg/dL had greater decline in eGFR ((β = -9.6, 95% CI -16.1, -3.1), comparing to those with a UA level less than 6 mg/dL. When stratifying patients into four UA categories, all three hyperuricemia categories (UA6-8, 8–10, ≥10 mg/dL) associated with a greater decline in eGFR over the follow-up period with an increasing dose-response, comparing to the lowest UA category. The risk of progression to renal failure increased 7% (hazard ratio 1.07, 95% CI 1.00, 1.14) for each 1mg/dL increase in baseline UA level. The influences of hyperuricemia on eGFR decline and the risk of kidney failure were more prominent in patients without proteinuria than those with proteinuria.ConclusionOur study showed a higher uric acid level is associated with a significant rapid decline in eGFR and a higher risk of kidney failure, particularly in patients without proteinuria. Our findings suggest hyperuricemia is a potential modifiable factor of CKD progression.

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“…Nevertheless, further analysis of our results showed a significant correlation of four quintiles of serum creatinine with serum uric acid values independent of diuretic use (Table 5). Our previous study on this issue [21] had demonstrated that serum uric acid may play a similar role to that of serum creatinine as an indicator of renal plasma flow. Thus, diuretic use in hypertensive patients may deplete renal plasma flow and consequently diminish uric acid and creatinine excretion.…”

Section: Tablementioning

confidence: 94%

Prevalence of hyperuricemia and its association with antihypertensive treatment in hypertensive patients in Taiwan

Lin

Lee

Hung

et al. 2012

International Journal of Cardiology

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A multicenter study of the association of serum uric acid, serum creatinine, and diuretic use in hypertensive patients

Cited by 26 publications

References 26 publications

Gender-Specific Relationship Between Serum Uric Acid Level and Atrial Fibrillation Prevalence

Gender-Specific Relationship Between Serum Uric Acid Level and Atrial Fibrillation Prevalence

Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review

Prevalence of hyperuricemia and its association with antihypertensive treatment in hypertensive patients in Taiwan

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