Association between uric acid and renal function in hypertensive patients: which role for systemic vascular involvement?

Geraci, Giulio; Mulè, Giuseppe; Morreale, Margherita; Cusumano, C.; Castiglia, Antonella; Gervasi, Francesca; D’Ignoto, Francesco; Mogavero, Manuela; Geraci, Calogero; Cottone, Santina

doi:10.1016/j.jash.2016.05.001

Cited by 11 publications

(6 citation statements)

References 35 publications

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“…We have noted hyperuricemia associates with an increased risk of fractures in elderly community-dwelling adults [ 17 ] and with coronary calcification in patients with type 1 diabetes mellitus [ 18 ]. Other groups have published similar findings associating asymptomatic hyperuricemia with coronary calcification [ 19 , 20 ] and with CIMT [ 21 , 22 ]. Based on these data, we hypothesized that lowering serum uric acid levels would improve CKD-MBD parameters and slow vascular calcification in patients with CKD.…”

Section: Introductionsupporting

confidence: 52%

Examining the effects of uric acid-lowering on markers vascular of calcification and CKD-MBD; A post-hoc analysis of a randomized clinical trial

Andrews¹,

Perrenoud²,

Nowak³

et al. 2018

PLoS ONE

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BackgroundChronic kidney disease (CKD)-mineral and bone disorder (MBD) is a systemic disorder that leads to vascular calcification and accelerated atherosclerosis. Uric acid has been shown to associate with vascular calcification and with carotid intima-media thickness (CIMT) and to suppress the 1 α-hydroxylase enzyme leading to lower 1,25-dihydroxyvitamin D (1,25(OH)2D) and higher intact parathyroid hormone (iPTH) levels. We hypothesized that lowering serum uric acid would reduce CIMT, calcification propensity, and circulating markers of CKD-MBD in CKD.MethodsThis is a post-hoc analysis of a randomized, double-blind study of 80 patients with stage 3 CKD and hyperuricemia who received allopurinol or placebo for 12 weeks. CIMT and T50 were measured as markers of vascular disease and serum calcification propensity, respectively. The following markers of CKD-MBD were measured: serum calcium, phosphorus, vitamin D metabolites, iPTH, and fibroblast growth factor-23 (FGF-23). Expression of extra-renal 1α-hydroxylase was evaluated in endothelial cells of study participants.FindingsAllopurinol successfully lowered serum uric acid levels compared to placebo with an estimate of -3.3 mg/dL (95% C.I. -4.1,-2.5; p < 0.0001). After 12 weeks, however, we found no significant change in CIMT or serum T50. There was not a significant change in vitamin D metabolites, iPTH, FGF-23, or the expression of endothelial 1α-hydroxylase.ConclusionThese data suggest that factors other than uric acid may play a more important role in the regulation of CKD- MBD including vascular calcification and vitamin D metabolism in patients with CKD.

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Section: Introductionsupporting

confidence: 52%

Examining the effects of uric acid-lowering on markers vascular of calcification and CKD-MBD; A post-hoc analysis of a randomized clinical trial

Andrews¹,

Perrenoud²,

Nowak³

et al. 2018

PLoS ONE

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“…For instance, a study conducted on 320 subjects, mean age 57.11 ± 15.47 years, with various degrees of abnormality in cardiac structure and function showed a significant correlation between PWVcf with CIMT and AIx (Yu et al 2008). In older hypertensive patients, aortic PWV (aPWV) significantly associated with CIMT and age, signifies the role of aging in AS (Geraci et al 2016). It has been shown that aging triggers the gradual replacement of the degenerated elastic fibres with collagenous fibres.…”

Section: Resultsmentioning

confidence: 99%

Association between Pulse Wave Velocity with Other Vascular Markers and Inflammation among Young Adults: An Evidence-based Review Norizam Salamt, Amilia Aminuddin, Azizah Ugusman & Aini Farzana Zulkefli

Salamt

Aminuddin²,

Ugusman³

et al. 2018

JSM

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Studies evaluating the association between pulse wave velocity (PWV), a gold standard measurement of aortic stiffness and established markers of cardiovascular disease (CVD), with other established vascular markers or inflammation among young adult is still scarce. A systematic review of the literature was conducted to identify relevant studies on the association between PWV with other vascular markers or inflammation. Relevant articles from Ovid Medline, Science Direct and Scopus databases were explored between 2009 and March 2018. Original articles published in English measuring any correlation between carotid-femoral PWV (PWVcf) with either augmentation index (AIx), carotid intima media thickness (CIMT) or C-reactive protein (CRP) on young adult with age range between 18 and 45 years old were included. The literature search identified 21 potential articles to be reviewed, which meet all the inclusion criteria. Four articles investigated the correlation between PWVcf with CRP, however only two studies gave significant but weak correlations. As for CIMT, a single relevant article was found and the correlation was not significant. In conclusion, lack of association between PWV and other vascular markers and inflammation may suggest that these vascular markers have their own property in assessing vascular status. Thus, these markers should be measured independently for comprehensive assessment of future CVD risk.

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“…A strong direct association is plausible between SUA and both structural and functional changes of arteries according to several studies. There is evidence that uric acid may play a causal role in the development of endothelial dysfunction and atherosclerosis [31]. It seems that uric acid has direct effects on impaired nitrogen oxide (NO) production and stimulating vascular smooth muscle cell (VSMC) proliferation causing endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Serum Uric Acid Is Independently Associated with Coronary Calcification in an Asymptomatic Population

Kiss

Bagyura

Csobay-Novák

et al. 2018

J. of Cardiovasc. Trans. Res.

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Detecting early-stage atherosclerosis is an important step towards cardiovascular disease prevention. Coronary artery calcium (CAC) score is a sensitive and non-invasive tool for detecting coronary atherosclerosis. Higher serum uric acid (SUA) levels are known to be associated with cardiovascular diseases. However, there is inconsistency regarding the independence of the association. The aim of our study was to assess the association of CAC and SUA in an asymptomatic population. CAC scans of 281 participants were analyzed in a voluntary screening program. A health questionnaire, physical examination, and laboratory tests were also performed. Participants with a history of cardiovascular disease were excluded from the analysis. 36.3% ( n = 102) of the participants had no detectable CAC and 13.9% ( n = 39) had a CAC score of > 300. SUA showed positive correlation with CAC score (0.175, p < 0.01). SUA was independently associated with Ca score > 300 (OR 5.17, p = 0.01) after the effects of conventional risk factors were eliminated.

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Association between uric acid and renal function in hypertensive patients: which role for systemic vascular involvement?

Cited by 11 publications

References 35 publications

Examining the effects of uric acid-lowering on markers vascular of calcification and CKD-MBD; A post-hoc analysis of a randomized clinical trial

Examining the effects of uric acid-lowering on markers vascular of calcification and CKD-MBD; A post-hoc analysis of a randomized clinical trial

Association between Pulse Wave Velocity with Other Vascular Markers and Inflammation among Young Adults: An Evidence-based Review Norizam Salamt, Amilia Aminuddin, Azizah Ugusman & Aini Farzana Zulkefli

Serum Uric Acid Is Independently Associated with Coronary Calcification in an Asymptomatic Population

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