Hyperuricemia: A Biomarker of Renal Hemodynamic Impairment

Sušić, Dinko; Fröhlich, Edward D.

doi:10.1159/000381317

Cited by 24 publications

(20 citation statements)

References 62 publications

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“…Renal function may be an important confounder for the prognostic value of SUA . However, the prognostic significance remained statistically significant after adjustment for estimated glomerular filtration rate.…”

Section: Discussionmentioning

confidence: 90%

Prognostic value of hyperuricemia in patients with acute coronary syndrome: A meta‐analysis

He¹,

Lin²,

Liu³

et al. 2019

Eur J Clin Investigation

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Background The prognostic significance of elevated circulating uric acid level in patients with acute coronary syndrome (ACS) is conflicting. This meta‐analysis aimed to assess the prognostic value of hyperuricemia in patients with ACS. Methods A comprehensive literature search was performed in Pubmed, Embase, VIP, CNKI and WanFang databases up to 16 June 2018. All observational studies that investigated the prognostic value of hyperuricemia in ACS patients were selected. Outcome of interests was major adverse cardiovascular events (MACEs), all‐cause mortality or cardiovascular mortality. Results A total of nine studies enrolling 8776 ACS patients were included and analysed. ACS patients with hyperuricemia had an increased risk of MACEs (risk ratio [RR]: 1.86; 95% confidence intervals [CI]: 1.47‐2.35), all‐cause mortality (RR 1.86; 95% CI: 1.49‐2.32) and cardiovascular mortality (RR: 1.74; 95% CI: 1.36‐2.22) after adjustment for the conventional risk factors. Stratified analysis showed that the prognostic significance of hyperuricemia was consistently observed in each subgroups. Conclusions This meta‐analysis suggests that hyperuricemia independently predicts MACEs and death in ACS patients. Determination of uric acid level has potential to improve risk stratification of adverse outcomes in ACS patients.

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Section: Discussionmentioning

confidence: 90%

Prognostic value of hyperuricemia in patients with acute coronary syndrome: A meta‐analysis

He¹,

Lin²,

Liu³

et al. 2019

Eur J Clin Investigation

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“…Firstly,majority of uric acid is excreted by the kidneys and accounts for 70%. It should be noted that approximately 90–95% of the filtered uric acid from glomerular is absorbed, mostly by proximal tubules [16, 17]. Secreted uric acid by the renal tubules is very little.…”

Section: Discussionmentioning

confidence: 99%

“…Seconding, an elevated SUA concentration has been found to be associated with damage of impartment organs and result to many diseases such as hypertension [17, 22], metabolic syndrome [23], atherosclerosis [24], myocardial infarction [25], diabetes mellitus [4], stroke [26] and so on. All of the above diseases are most common risk factor of AKI, which make it sense that the incidence of AKI in the hyperuricemic patients is higher than those in the normouricemic patients.…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia increases the risk of acute kidney injury: a systematic review and meta-analysis

Song

et al. 2017

BMC Nephrol

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BackgroundMounting evidence indicated that the elevated serum uric acid level was associated with an increased risk of acute kidney injury (AKI). Our goal was to systematically evaluate the correlation of serum uric acid (SUA) level and incidence of AKI by longitudinal cohort studies.MethodsWe searched electronic databases and the reference lists of relevant articles. 18 cohort studies with 75,200 patients were analyzed in this random-effect meta-analysis. Hyperuricemia was defined as SUA levels greater than 360-420 μmol/L (6–7 mg/dl), which was various according to different studies. Data including serum uric acid, serum creatinine, and incidence of AKI and hospital mortality were summarized using random-effects meta-analysis.ResultsThe hyperuricemia group significantly exerted a higher risk of AKI compared to the controls (odds ratio OR 2.24, 95% CI 1.76-2.86, p < 0.01). Furthermore, there is less difference of the pooled rate of AKI after cardiac surgery between hyperuricemia and control group (34.3% vs 29.7%, OR 1.24, 95% CI 0.96-1.60, p = 0.10), while the rates after PCI were much higher in hyperuricemia group than that in control group (16.0% vs 5.3%, OR 3.24, 95% CI 1.93-5.45, p < 0.01). In addition, there were significant differences in baseline renal function at admission between hyperuricemia and control groups in most of the included studies. The relationship between hyperuricemia and hospital mortality was not significant. The pooled pre-operative SUA levels were higher in AKI group than that in the non-AKI group.ConclusionsElevated SUA level showed an increased risk for AKI in patients and measurements of SUA may help identify risks for AKI in these patients.

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“…For example, there is evidence for a hypothalamus selective resistance to the metabolic actions leptin while its sympathetic nervous system activation effects on organs such as the kidneys are maintained [59]. The proinflammatory adipocytokine tumor necrosis factor α has been shown to promote macrophage recruitment and infiltration with consequent glomerular and tubulointerstitial inflammation as well as to promote upregulation of other inflammatory cytokines which promote kidney tissue fibrosis [64,65,66,67,68]. On the other end of the spectrum in obesity, there is a reduction in the anti-inflammatory adiponectin, and this reduction is associated with increases in albuminuria as well as kidney tissue fibrosis [62,65].…”

Section: Impact Of Obesity On the Kidney Distinct From That Of The Prmentioning

confidence: 99%

Insulin Resistance in Kidney Disease: Is There a Distinct Role Separate from That of Diabetes or Obesity

Whaley‐Connell¹,

Sowers

2017

Cardiorenal Med

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Insulin resistance is a central component of the metabolic dysregulation observed in obesity, which puts one at risk for the development of type 2 diabetes and complications related to diabetes such as chronic kidney disease. Insulin resistance and compensatory hyperinsulinemia place one at risk for other risk factors such as dyslipidemia, hypertension, and proteinuria, e.g., development of kidney disease. Our traditional view of insulin actions focuses on insulin-sensitive tissues such as skeletal muscle, liver, adipose tissue, and the pancreas. However, insulin also has distinct actions in kidney tissue that regulate growth, hypertrophy, as well as microcirculatory and fibrotic pathways which, in turn, impact glomerular filtration, including that governed by tubuloglomerular feedback. However, it is often difficult to discern the distinct effects of excess circulating insulin and impaired insulin actions, as exist in the insulin resistance individual, from the associated effects of obesity or elevated systolic blood pressure on the development and progression of kidney disease over time. Therefore, we review the experimental and clinical evidence for the distinct impact of insulin resistance on kidney function and disease.

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Hyperuricemia: A Biomarker of Renal Hemodynamic Impairment

Cited by 24 publications

References 62 publications

Prognostic value of hyperuricemia in patients with acute coronary syndrome: A meta‐analysis

Prognostic value of hyperuricemia in patients with acute coronary syndrome: A meta‐analysis

Hyperuricemia increases the risk of acute kidney injury: a systematic review and meta-analysis

Insulin Resistance in Kidney Disease: Is There a Distinct Role Separate from That of Diabetes or Obesity

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