A systematic review and meta-analysis of the association between uric acid levels and chronic kidney disease

Gonçalves, Danilo Lemes Naves; Moreira, Tiago Ricardo; Silva, Luciana Saraiva da

doi:10.1038/s41598-022-10118-x

Cited by 18 publications

(6 citation statements)

References 57 publications

(61 reference statements)

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“…This regulation of urinary acid-base balance not only helps lower serum uric acid levels but may also alleviate the burden on the kidneys. [ 23 , 24 ] Long-term high UA levels can lead to kidney stones and renal damage; therefore, by lowering serum uric acid levels, alkaline water may offer indirect benefits in protecting kidney health. Additionally, by promoting UA excretion, alkaline water may indirectly reduce UA deposition in joints and soft tissues, thereby alleviating or preventing symptoms of gouty arthritis.…”

Section: Discussion and Analysismentioning

confidence: 99%

Assessment of the efficacy of alkaline water in conjunction with conventional medication for the treatment of chronic gouty arthritis: A randomized controlled study [RETRACTED]

Wu,

Pang,

Guo

et al. 2024

Medicine

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Background: Chronic gouty arthritis, a prevalent metabolic disorder, has prompted interest in the role of diet and lifestyle in its management. This study examines alkaline water as a non-pharmacological adjunct to traditional medicine, hypothesizing its positive effects on uric acid levels and gout symptoms. Methods: In this research, 400 chronic arthritis patients from Guangdong Hydropower Hospital (September 2021–September 2023) were randomly assigned to groups receiving varying concentrations of alkaline water alongside conventional Western medicine, or Western medicine alone. A 1-year follow-up involved assessments using visual analogue scales, joint swelling scores, functional assessment scales, and biochemical markers (serum uric acid, creatinine, urea nitrogen) for comprehensive evaluation. Results: Pain relief: High-concentration alkaline water significantly reduced VAS pain scores posttreatment (P < .05). Joint swelling: Greatest improvement observed in high-concentration group (P < .001). Daily activity capability: Notable enhancements in daily activity scores in experimental groups (P < .05). Range of joint motion: All groups showed significant improvement posttreatment (P < .05). Inflammatory markers: Experimental groups experienced a notable decrease in C-reactive protein, especially in the low concentration group (P < .001). Erythrocyte sedimentation rate decreases were marginal and not statistically significant (P > .05). Interleukin-1β and tumor necrosis factor-α levels significantly decreased, particularly in the low concentration group. Serum uric acid levels: Significant reduction in serum uric acid observed in all alkaline water groups (P < .05), contrasting with the control group. Conclusion: Alkaline water, particularly at high concentrations, effectively alleviated pain, reduced joint swelling, enhanced daily activities, and improved joint motion in chronic gouty arthritis treatment. It significantly reduced key inflammatory markers (C-reactive protein, interleukin-1β, tumor necrosis factor-α) and serum uric acid levels, suggesting its potential as a valuable adjunct in gout management. The limited impact on erythrocyte sedimentation rate warrants further investigation.

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Section: Discussion and Analysismentioning

confidence: 99%

Assessment of the efficacy of alkaline water in conjunction with conventional medication for the treatment of chronic gouty arthritis: A randomized controlled study [RETRACTED]

Wu,

Pang,

Guo

et al. 2024

Medicine

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“…However, another study showed different results about an inverse relationship between SUA levels and protection from CKD incidence and progression. Lower UA levels were protective for the risk of CKD incidence (RR 0.65 [95% CI 0.56-0.75]) and progression (RR 0.55 [95% CI 0.44-0.68]) ( 28 ). The results that we obtained also support this conclusion.…”

Section: Discussionmentioning

confidence: 99%

Relationship between serum uric acid and estimated glomerular filtration rate in adolescents aged 12-19 years with different body mass indices: a cross-sectional study

Tian

Wang

et al. 2023

Front. Endocrinol.

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BackgroundGlobally, chronic kidney disease (CKD) is a growing public health concern. Serum uric acid (SUA) is an easily detectable and readily available biochemical indicator that has long been recognized as an independent risk factor for CKD. In addition, studies have indicated a potential relationship between SUA and body mass index (BMI). However, studies on the effect of SUA levels on the estimated glomerular filtration rate (eGFR) in adolescents with different BMIs are very rare.MethodsWeighted multiple regression analysis was used to estimate the independent relationship between SUA and log-transformed eGFR. Additionally, we used a weighted generalized additive model and smooth curve fitting to describe the nonlinear relationships in the subgroup analysis.ResultsFirst, SUA was negatively associated with log-transformed eGFR even after adjusting for all covariates (β=-0.0177, 95% CI: -0.0203-0.0151, P<0.0001). Second, the results of the stratified analysis found that after adjusting for all covariates, the decrease in log-transformed eGFR due to changes in per SUA levels (Per 1, mg/dL increase) was elevated in female adolescents (β=-0.0177, 95% CI: -0.0216, -0.0138, P<0.0001), adolescents aged 12-15 years (β=-0.0163, 95% CI: -0.0200, -0.0125, P<0.0001) and black (β=-0.0199, 95% CI: -0.0251, -0.0148, P<0.0001) adolescents. Furthermore, we found that adolescents with a higher BMI had higher SUA levels, and the effect of SUA on eGFR was significantly higher in underweight adolescents (β=-0.0386, 95% CI: (-0.0550, -0.0223), P<0.0001).ConclusionSUA was negatively associated with the eGFR in adolescents aged 12-19 years. Furthermore, we found for the first time that SUA affects the eGFR differently in adolescents with different BMIs. This effect was particularly significant in underweight adolescents.

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“…These include CVD, HTN, CKD, and most features of the metabolic syndrome (obesity, insulin resistance, etc.) 13 14 The association of hyperuricemia with these disorders has been documented in both children and adults.…”

Section: The Role Of Uric Acid In the Pathogenesis Of Diseasementioning

confidence: 99%

The Impact of Uric Acid on Human Health: Beyond Gout and Kidney Stones

Anaizi

2023

Ibnosina Journal of Medicine and Biomedical Sciences

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In most primates, including humans, uric acid (UA) is the end product of purine metabolism due to the loss of hepatic uricase activity during evolution. This loss resulted in higher serum urate concentrations (3.5–7.5 mg/dL) than normally observed in other mammals (0.05–2 mg/dL). About 70% of the daily urate burden is eliminated via the kidneys and the remainder via the intestines, where gut bacteria break it down. Urate is freely filtered through the glomerular capillaries, and most of the filtered urate is reabsorbed so that only an amount equivalent to about 10% of the filtered load is excreted in the urine. Virtually all of the renal urate reabsorption takes place in proximal convoluted tubules. Many transport proteins connected with urate have been identified. However, the best studied are URAT1 and GLUT9, which function in concert to translocate urate from the proximal tubule lumen to the peritubular fluid, the first in the apical membrane and the second in the basolateral membrane. Genetic mutations, as well as drugs that alter the function of these transporters, can affect urate homeostasis resulting in abnormal serum levels, which may, in turn, be involved in the pathogenesis of chronic metabolic and inflammatory diseases, including most features of the metabolic syndrome, hypertension, cardiovascular disease, and chronic kidney disease. Several mechanisms are thought to provide the link between urate and these disorders, including reactive oxygen species (oxidative stress) and both acute and chronic inflammation. This mini-review summarizes the basic human biology of UA and its association with and potential involvement in developing chronic diseases beyond gout and nephrolithiasis.

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A systematic review and meta-analysis of the association between uric acid levels and chronic kidney disease

Cited by 18 publications

References 57 publications

Assessment of the efficacy of alkaline water in conjunction with conventional medication for the treatment of chronic gouty arthritis: A randomized controlled study [RETRACTED]

Assessment of the efficacy of alkaline water in conjunction with conventional medication for the treatment of chronic gouty arthritis: A randomized controlled study [RETRACTED]

Relationship between serum uric acid and estimated glomerular filtration rate in adolescents aged 12-19 years with different body mass indices: a cross-sectional study

The Impact of Uric Acid on Human Health: Beyond Gout and Kidney Stones

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