Effect of angiotensin and norepinephrine upon urate clearance in man

Ferris, Thomas F.; Görden, Phillip

doi:10.1016/0002-9343(68)90107-1

Cited by 143 publications

(55 citation statements)

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“…There is strong evidence that renal vasoconstriction results in increased proximal urate reabsorption and an increase in serum UA. 30 In addition, our data in the present study are in a good accordance with the studies of Jossa et al 6 and Selby et al, 7 that UA is an independent predictor of hypertension in the general population, and also the studies in which a high heart rate, which is a known marker of sympathetic overactivity, predicts hypertension.…”

Section: Discussionsupporting

confidence: 93%

“…Some investigators have suggested that hyperuricemia might be a secondary response to the reduced renal blood flow that is a characteristic hemodynamic finding in hypertension. 1,30 However, Johnson et al 31 hypothesized that vasoconstriction reduces renal blood flow, leading to renal microvascular and tubulointerstitial injury and resultant hypertension, and that hyperuricemia might be an independent predictor of hypertension. They also reviewed more recently the pathogenic role of UA in hypertension in both human and animal models.…”

Section: Discussionmentioning

confidence: 99%

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Serum Uric Acid and Plasma Norepinephrine Concentrations Predict Subsequent Weight Gain and Blood Pressure Elevation

et al. 2003

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Abstract-It has been reported that hypertension and obesity often coexist with hyperuricemia. To clarify the relations between serum uric acid, plasma norepinephrine, and insulin or leptin levels in subjects with weight gain-induced blood pressure elevation, we conducted the present longitudinal study. In 433 young, nonobese, normotensive men, body mass index, blood pressure, and levels of serum uric acid, fasting plasma norepinephrine, insulin, and leptin were measured every year for 5 years. Subjects were stratified by significant weight gain and/or blood pressure elevation (Ͼ10% in body mass index or mean blood pressure) for 5 years. At entry, blood pressure, uric acid, and norepinephrine values in subjects with blood pressure elevation were greater than in those without it, although body mass index, insulin, and leptin were similar. At entry, body mass index, blood pressure, uric acid, and norepinephrine in subjects with weight gain were greater than in those without weight gain. The increases in body mass index, mean blood pressure, uric acid, norepinephrine, insulin, and leptin for 5 years were greater in subjects with blood pressure elevation and/or weight gain than in subjects without, and those increases were greatest in subjects with weight gain whose blood pressure was elevated. By multiple regression analysis, basal mean blood pressure, norepinephrine, and uric acid were significant determinant factors of changes in mean blood pressure over 5 years, and basal body mass index, norepinephrine, and uric acid were significant determinant factors of changes in body mass index. These results demonstrate that serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation. Key Words: uric acid Ⅲ sympathetic nervous system Ⅲ obesity Ⅲ hypertension, obesity E levated serum uric acid (UA) is associated with increased rates of cardiovascular events, 1-3 and hyperuricemia is frequently observed in obese subjects and hypertensive patients. 4 -8 Several lines of evidence, both epidemiologic and clinical, point to a close interrelation between hyperuricemia, hypertension, and obesity. 2-8 Also, it is known that both hypertension and obesity are related to sympathetic overactivity, 9 -17 hyperinsulinemia, and insulin resistance. 18,19 However, the relation of insulin resistance and sympathetic nervous overactivity to hypertension and obesity is still controversial. 11,15,20 These and other investigations have documented the coexistence of elevated UA level, sympathetic overactivity, and hyperinsulinemia in hypertension and obesity, but the precise relation has not been clarified.The goal of the present longitudinal study was to clarify the interrelation of serum UA level, sympathetic activity, insulin, and leptin levels in subjects with weight gain-induced blood pressure (BP) elevation. We sequentially studied the accompaniments of spontaneous weight gain-induced BP elevation for 5 years, especially focusing on serum UA, sympathetic activity, and plasma levels of ...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Serum Uric Acid and Plasma Norepinephrine Concentrations Predict Subsequent Weight Gain and Blood Pressure Elevation

et al. 2003

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“…However, the increase in UA levels is too large to be attributed solely to the reduction of glomerular filtration rate; thus, there must also be decreased secretion or increased reabsorption. This phenomenon appears to be analogous to the decrease in urate clearance produced by the infusion of vasoconstrictors, such as norepinephrine, 22 and to the increase of blood UA level and diminution in its clearance observed in glomerulonephritis. 23 According to these considerations, UA could be an early marker of preeclampsia.…”

Section: Discussionmentioning

confidence: 66%

Prognostic Significance of Serum Uric Acid in Women With Gestational Hypertension

et al. 2011

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Abstract-Aim of our study was to ascertain, prospectively, whether serum uric acid is a suitable predictor of preeclampsia and/or the delivery of small-for-gestational-age infants in women with gestational hypertension. We screened 206 primiparas, with a singleton pregnancy, referred for recent onset of hypertension. At presentation, we measured serum uric acid, creatinine, blood glucose, hemoglobin and platelet level, and 24-hour proteinuria, as well as office and 24-hour blood pressures. We followed the women until 1 month after delivery and recorded pregnancy outcome. After logistic regression analysis, uric acid resulted a significant predictor of preeclampsia, with an unadjusted odds ratio of 9.1 (95% CI: 4.8 to 17.4; PϽ0.001); after adjustment for age, gestation week, hemoglobin and platelet levels, serum creatinine, office and 24-hour average systolic and diastolic blood pressures, it was 7.1 (95% CI: 3.2 to 15.7; PϽ0.001). Regarding the association between maternal serum uric acid and the chance of giving birth to a small-for-gestational-age infant, the unadjusted odds ratio was 1.7 (95% CI: 1.4 to 2.2; PϽ0.001), and it was 1.6 (95% CI: 1.1 to 2.4; Pϭ0.02) after adjustment. Receiver operating characteristic analysis showed that serum uric acid, at a 309-mol/L cutoff, predicted the development of preeclampsia (area under the curve: 0.955), with 87.7% sensitivity and 93.3% specificity, and the delivery of small-for-gestational-age infants (area under the curve: 0.784) with 83.7% sensitivity and 71.7% specificity.In conclusion, the results of our study show that serum uric acid is a reliable predictor of preeclampsia in women referred for gestational hypertension. (Hypertension. 2011;58:704-708.)Key Words: uric acid Ⅲ preeclampsia Ⅲ gestational hypertension Ⅲ blood pressure Ⅲ small for gestation age H ypertensive disorders complicate Ϸ2% to 10% of all pregnancies. 1,2 Among these, preeclampsia remains one of the largest single causes of maternal and fetal mortality and morbidity, whereas uncomplicated gestational hypertension carries a far better prognosis. Clinical prediction of preeclampsia may facilitate initiation of timely management to avert mortality and morbidity in the mother and infant. Raised serum uric acid (UA) is one of the characteristic findings in preeclampsia. In clinical practice, serum UA determination is considered to be a part of the workup in women with preeclampsia to monitor disease severity and aid management of these women. The association between raised serum UA and preeclamptic pregnancies was first reported almost a century ago. 3 Reduced UA clearance secondary to reduced glomerular filtration rate, increased reabsorption, and decreased secretion may be at the origin of elevated serum levels in women with preeclampsia. 4,5 Several studies have reported a positive correlation between elevated maternal serum UA and adverse maternal and fetal outcomes. 6 -10 A number of studies 11-15 have evaluated several tests and parameters, including UA, during the first or second trimester of...

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“…As well as increasing blood pressure, infusion of angiotensin II was found to reduce the fractional renal clearance of UA (i.e., the ratio of UA clearance to creatinine clearance) 7 . Additionally, water loading (the provision of large volumes of water prior to study participation) is associated with an increase in fractional clearance of UA 8 , and in this situation, the RAS is less active.…”

Section: To the Editormentioning

confidence: 99%