Hyperuricemia, urine uric excretion, and associated complications in thalassemia patients

Chaloemwong, Juthatip; Tantiworawit, Adisak; Rattanathammethee, Thanawat; Chai‐Adisaksopha, Chatree; Rattarittamrong, Ekarat; Norasetthada, Lalita; Charoenkwan, Pimlak; Louthrenoo, Worawit

doi:10.1007/s00277-019-03630-0

Cited by 15 publications

(18 citation statements)

References 39 publications

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“…We observed that proportion of hyperuricemia was more in subjects with intact spleen than splenectomised subjects, however, the difference was not statistically significant (p=0.104). In a cross sectional study done by Chaloemwong et al [20] on 112 thalassemic patients and proportion of splenectomised patients was high -59.8% (n=67). They observed that intact spleen was a risk factor for hyperuricemia (p=0.01).…”

Section: Discussionmentioning

confidence: 95%

“…Majority of the subjects were in the age group of 21-30 years (58.33%). Chaloemwong et al [11] studied 58 thalassemia patients with mean age of 23.5 years .…”

Section: Discussionmentioning

confidence: 99%

“…Our study observed that mean value of SUA increased proportionately as the age of the subjects increased which was statistically significant (p=0.0129). Chaloemwong et al [11] studied 58 thalassemia patients with mean age of 23.5 years observed that increasing age was a significant risk factor for hyperuricemia (p=0.046).…”

Section: Discussionmentioning

confidence: 99%

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Uric Acid Abnormalities and Its Correlation with Splenectomy in Adult Transfusion Dependent Thalassemia Subjects (TDT)

Sahithi¹,

Aggarwal²,

Prakash³

et al. 2021

annhematoloncol

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Background: In thalassemia patients erythrocyte turnover rate increases due to chronic hemolysis and ineffective erythropoiesis leading to increase in uric acid production. Hyperuricosuria is one of the marker of proximal tubular dysfunction. Splenectomy can increase the risk of hyperuricemia by increasing erythrocyte turnover rate in Transfusion Dependent Thalassemia (TDT). Deferasirox enhances uric acid excretion from renal tubules leading to low serum uric acid levels. Methods: An institution based cross-sectional study was conducted from November 2018-March 2020 which included 60 adult TDT patients (≥18 years) attending Adult Thalassemia Day Care Centre at tertiary care hospital. Serum uric acid (mg/dl), 24 hour urinary uric acid (mg/dl), serum ferritin (ng/ml) were done. Results: Hyperuricemia was present in 20%, hypouricemia in 3.33%. Hyperuricosuria was present in 80%. Mean SUA levels were higher in males than females which was statistically significant (5.77±1.66 vs 4.64±1.44, p=0.007). There was statistically significant positive correlation between serum uric acid and serum creatinine(p = 0.0036) and age (p=0.0129). Hyperuricemia was more in subjects with intact spleen but was not statistically significant(p=0.104). Hyperuricemia had negative association with deferasirox therapy [1 (3.03%) vs 11 (40.74%), p=0.0004] compared with normouricemia subjects. Conclusion: Uric acid abnormalities were seen in 23.3% of patients. Hyperuricemia was present in one fourth of the patients and significant risk factors were increasing age, male gender, rising serum creatinine. Deferasirox therapy was negatively associated with hyperuricemia. Tubular dysfunction is relatively common in TDT as more than three fourth patients had hyperuricosuria. Regular monitoring of serum uric acid and urinary uric acid is recommended.

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Section: Discussionmentioning

confidence: 95%

“…Majority of the subjects were in the age group of 21-30 years (58.33%). Chaloemwong et al [11] studied 58 thalassemia patients with mean age of 23.5 years .…”

Section: Discussionmentioning

confidence: 99%

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Uric Acid Abnormalities and Its Correlation with Splenectomy in Adult Transfusion Dependent Thalassemia Subjects (TDT)

Sahithi¹,

Aggarwal²,

Prakash³

et al. 2021

annhematoloncol

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“…Elevated uric acid has long been associated with several complications [16]. Newly studies of the pathological mechanism of gout disease illustrated that hyperuricemia associated with insight into the underlying mechanisms of monosodium urate crystals induce an inflammatory reaction involved in the pathology of gout by the deposition of monosodium urate crystals within joints and connective tissue engenders highly inflammatory but localized responses [17].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Biomarkers Status and Liver Enzymes Among Hyperuricemia Patients in Gaza Strip

Mustafa¹

2019

ACCS

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Background:The significance of hyperuricemia as a risk factor of incidence of myocardial infarction has been a debate for recent decades. However, Hyperuricemia has been shown to predict the development of heart failure, elevated in weight, hyper-insulinemia of secondary hypertension. Several studies have demonstrated that hyperuricemia is also associated with elevated inflammatory biomarkers levels and development of nonalcoholic fatty liver disease (NAFLD). The aims of the present study were to assess inflammatory biomarkers status and liver enzymes among hyperuricemia patients in Gaza Strip Materials and Methods: A case-control study has been conducted on 70 subjects with hyperuricemia and 70 healthy subjects with normal uric acid as control aged between 41-70 years. Erythrocyte sedimentation rate (ESR), C -reactive protein (CRP), complement 3 (C3), ferritin, fibrinogen and liver enzymes were measured. Results:The results pointed out the average levels of ESR, CRP, C3, ferritin, fibrinogen AST and ALT were significantly higher in cases compared to controls. Pearson correlation showed that a positive significant correlation between uric acid and CRP (r = 0.

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“…Heart abnormalities are still mainly caused by chronic iron deposition in myocytes which results in an increase in oxidative stress, inducing myocyte injury, increased myocardial fibrosis and decreased cardiac contraction [10]. Renal abnormalities in cases of thalassemia manifest themselves through tubular dysfunction, glomerular dysfunction, hyperfiltration and renal stones caused by chronic hemolytic anemia and chelation therapy [11][12][13][14][15][16][17]. A coexistence of cardiac and renal abnormalities is known as 'Cardiorenal syndrome (CRS)'.…”

Section: Introductionmentioning

confidence: 99%

Cardiorenal syndrome in thalassemia patients

et al. 2020

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Background: Cardiorenal syndrome (CRS), a serious condition with high morbidity and mortality, is characterized by the coexistence of cardiac abnormality and renal dysfunction. There is limited information about CRS in association thalassemia. This study aimed to investigate the prevalence of CRS in thalassemia patients and also associated risk factors. Methods: Thalassemia patients who attended the outpatient clinic of a tertiary care university hospital from October 2016 to September 2017 were enrolled onto this cross-sectional study. Clinical and laboratory findings from 2 consecutive visits, 3 months apart, were assessed. The criteria for diagnosis of CRS was based on a system proposed by Ronco and McCullough. Cardiac abnormalities are assessed by clinical presentation, establishment of acute or chronic heart failure using definitions from 2016 ESC guidelines or from structural abnormalities shown in an echocardiogram. Renal dysfunction was defined as chronic kidney disease according to the 2012 KDIGO guidelines. Results: Out of 90 thalassemia patients, 25 (27.8%) had CRS. The multivariable analysis showed a significant association between CRS and extramedullary hematopoiesis (EMH) (odds ratio (OR) 20.55, p = 0.016); thalassemia type [β 0 /β E vs β 0 /β 0 thalassemia (OR 0.005, p = 0.002)]; pulmonary hypertension (OR 178.1, p = 0.001); elevated serum NT-proBNP (OR 1.028, p = 0.022), and elevated 24-h urine magnesium (OR 1.913, p = 0.016). There was no association found between CRS and frequency of blood transfusion, serum ferritin, liver iron concentration, cardiac T2*, type of iron chelating agents, or urine neutrophil gelatinase-associated lipocalin level. Conclusions: CRS is relatively common in thalassemia patients. Its occurrence is associated with laboratory parameters which are easily measured in clinical practice.

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Hyperuricemia, urine uric excretion, and associated complications in thalassemia patients

Cited by 15 publications

References 39 publications

Uric Acid Abnormalities and Its Correlation with Splenectomy in Adult Transfusion Dependent Thalassemia Subjects (TDT)

Uric Acid Abnormalities and Its Correlation with Splenectomy in Adult Transfusion Dependent Thalassemia Subjects (TDT)

Inflammatory Biomarkers Status and Liver Enzymes Among Hyperuricemia Patients in Gaza Strip

Cardiorenal syndrome in thalassemia patients

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