Associations between Hyperuricemia and Chronic Kidney Disease: A Review

Abstract

Context:In human beings, uric acid is the poorly soluble circulating end product of the purine nucleotide metabolism. A reduction in the glomerular filtration rate (GFR) contributes to hyperuricemia, which is frequently observed in patients with chronic kidney disease (CKD).Evidence Acquisition:Hyperuricemia is defined as a serum uric acid level > 7.0 mg/dL in males and > 6.0 mg/dL in females, while CKD is defined as kidney damage or a GFR < 60 mL/min/1.73 m2 for 3 months or more, irrespective of the cause. Hyperuricemia is common in CKD and may occur because of decreased excretion, increased production, or a combination of both mechanisms.Results:The causes for hyperuricemia in overproducers may be either exogenous or endogenous. CKD has become a global public health problem because of its high prevalence and the accompanying increase in the risk of end-stage renal disease, cardiovascular disease, and premature death. The most common risk factors for CKD are obesity and the metabolic syndrome, which is strongly associated with hyperuricemia probably as a consequence of insulin resistance and the effects of insulin to reduce the urinary urate excretion. For recurring bouts of hyperuricemia or gout, patients should have a blood test and joint fluid test to determine whether the medication taken is effective. Interventional studies are a useful clinical research tool in clarifying the role of hyperuricemia in CKD.Conclusions:Although many evidence-based studies have suggested that uric acid itself may harm patients with CKD by increasing inflammation and CKD progression, the issue is still a matter of controversy. Special attention should be paid to specific contraindications to certain drugs and the possibility of infectious arthritis.

Association between serum uric acid levels and metabolic markers in patients with type 2 diabetes from a community with high diabetes prevalence

“…Serum urea and creatinine were elevated in hyperuricemic patients, suggesting impaired kidney function. Hyperuricemia is known to be associated with the decrease in kidney function and because chronic kidney disease itself elevates SUA level, it is difficult to interpret the causes of the elevated serum urea and creatinine in hyperuricemia. However, eGFR values were only slightly lower in hyperuricemic patients.…”

Role of NADPH Oxidase in Metabolic Disease‐Related Renal Injury: An Update

“…The role of UA in CKD remains controversial, and the “UA debate” has been going on for decades [87]. UA has been considered as a major antioxidant in protecting cells from oxidative injury proved by abundant experimental and clinical evidence [88].…”

Hypouricemic and Nephroprotective Effects of an Active Fraction from <b><i>Polyrhachis Vicina Roger</i></b> On Potassium Oxonate-Induced Hyperuricemia in Rats

“…In the present study, serum uric acid levels were significantly increased 8 and 12 weeks after potassium oxonate administration, suggesting the successful establishment of hyperuricemia model. Elevated serum uric acid levels may contribute to chronic kidney disease development and progression [50], indicating that in the present study hyperuricemia lead to shrinking of brush border shown in Fig. 7, instead of vice versa.…”