Is High Serum Uric Acid a Risk Marker or a Target for Treatment? Examination of its Independent Effect in a Large Cohort With Low Cardiovascular Risk

Wen, Chi Pang; Cheng, Ting; Chan, Hui Ting; Tsai, Min Kuang; Chung, Wen Shen Isabella; Tsai, Shan P.; Wahlqvist, Mark L.; Yang, Yi; Wu, Shiuan Be; Chiang, Po Huang; Wen, Sung-Feng

doi:10.1053/j.ajkd.2010.01.024

Cited by 77 publications

(59 citation statements)

References 42 publications

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“…3,116,117 However, according to other studies, this correlation diminished after adjustment for GFR or proteinuria. 118,119 Moreover, Madero et al 3 found that CKD patients with high serum UA concentration had a higher risk for all-cause and CV mortality. Similar, Kanbay et al 120 reported that HUA predicts CV events in advanced CKD stages.…”

Section: Hua and CV Mortalitymentioning

confidence: 99%

Hyperuricemia and chronic kidney disease: an enigma yet to be solved

et al. 2014

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The role of uric acid (UA) on the pathogenesis and progression of chronic kidney disease (CKD) remains controversial. Experimental and clinical studies indicate that UA is associated with several risk factors of CKD including diabetes, hypertension, oxidative stress, and inflammation and hyperuricemia could be considered as a common dominator linking CKD and cardiovascular disease. Notably, the impact of serum UA levels on the survival of CKD, dialysis patients, and renal transplant recipients is also a matter of debate, as there are conflicting results from clinical studies. At present, there is no definite data whether UA is causal, compensatory, coincidental or it is only an epiphenomenon in these patients. In this article, we attempt to review and elucidate the dark side of this old molecule in CKD and renal transplantation.

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Section: Hua and CV Mortalitymentioning

confidence: 99%

Hyperuricemia and chronic kidney disease: an enigma yet to be solved

et al. 2014

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“…7 Recent data also indicate that serum uric acid (UA) is a risk marker for progression of chronic kidney disease. [8][9][10] The angiotensin II receptor blocker (ARB) losartan has been shown to increase urinary UA excretion and, consequently, to decrease serum UA level. 11,12 However, other ARBs, such as candesartan and valsartan, do not lower serum UA level.…”

Section: Introductionmentioning

confidence: 99%

Impact of irbesartan, an angiotensin receptor blocker, on uric acid level and oxidative stress in high-risk hypertension patients

et al. 2015

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Hyperuricemia is a known cardiovascular risk factor. The angiotensin II receptor blocker (ARB) losartan is known to decrease serum uric acid (UA) level. A recent in vitro study demonstrated a strong interaction between irbesartan and UA transporters that exceeded that of losartan. The purpose of the present study was to evaluate the hypouricemic effect of irbesartan in a clinical setting. A total of 40 high-risk hypertensive outpatients with coronary artery disease, cerebrovascular disease and/or diabetes complications who were taking ARBs other than irbesartan and losartan were enrolled in this study. After a 4-week control period, the patients' prescribed ARBs were exchanged for an equivalent dose of irbesartan. We assessed blood pressure, heart rate, serum UA level, parameters of lipid and glucose metabolism, cardiac and renal function and inflammatory and oxidative stress markers in blood samples taken immediately before the initiation of irbesartan treatment and again after 12 weeks of treatment. All 40 recruited patients were followed (31 men and 9 women, mean age: 68 years) without any dropouts. During the 12 weeks of irbesartan treatment, no significant changes in blood pressure, heart rate, parameters of lipid or glucose metabolism or other biomarkers of cardiac function, renal function, or inflammation were observed. However, UA level (5.9±1.6 to 5.5±1.6 mg ml(-1), P=0.028) and the oxidative stress marker derivative reactive oxygen metabolites (dROMs) (354±83 to 310±65 U.CARR, P<0.001) were significantly lower at 12 weeks of treatment compared with before treatment. These results suggest that irbesartan has beneficial effects on hyperuricemia and oxidative stress.

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“…The average SUA levels and prevalence of hyperuricemia were higher in the Chinese population in Taiwan as compared with those of other ethnic groups [9,10]. Accordingly, it is timely and crucial to understand the impact of SUA on hypertension risk in Taiwan.…”

Section: Introductionmentioning

confidence: 99%