Is serum uric acid a predictor of long-term renal outcome in lupus nephritis?

Ugolini-Lopes, Michelle Remião; Gavinier, S.S.; Leon, Elaine Pires; Viana, Vilma T; Borba, Eduardo F.; Bonfá, Eloísa

doi:10.1007/s10067-019-04620-3

Cited by 12 publications

(19 citation statements)

References 32 publications

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“…23 Our study revealed that the best cut-off point for the SUA level to predict LN development in SLE patients was >4.9 mg/dL, with a sensitivity of 83.3% and specificity of 70.0%. Our results were close to those of Ugolini-Lopes et al, who reported a sensitivity of 0.67, specificity of 0.89, PPV of 0.85, and NPV of 0.73, 22 but opposite to those of Lopes et al, who reported a sensitivity of 0.63, specificity of 0.65, PPV of 0.38, and NPV of 0.16, 95%. 24 As early diagnosis and treatment of hyperuricemia are of great importance for the improvement in the clinical outcomes of LN, SUA level measurement should be conducted as a routine test to predict LN development in SLE patients.…”

Section: Discussionsupporting

confidence: 82%

“…Our study revealed that the SUA level was significantly positively correlated with urea and creatinine levels and proteinuria (p < 0.001) but was significantly negatively correlated with creatinine clearance (p < 0.001), which is consistent with the results obtained by Ugolini-Lopes et al, who proposed that the SUA level could be a good predictor of LN development in SLE patients. 22 Xie et al also yielded similar findings; they reported that serum BUN and creatinine levels were significantly higher in LN patients with hyperuricaemia (p < 0.05) and that the estimated glomerular filtration rate was significantly lower in the same patients (p < 0.05). 18 The SUA level was positively correlated with the degree of renal damage in LN patients, as our study identified a significant positive correlation between SUA level, renal biopsy class, and AI score (p < 0.05) and a highly significant positive correlation with the CI score (p < 0.001).…”

Section: Discussionmentioning

confidence: 58%

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Serum uric acid as a predictor for nephritis in Egyptian patients with systemic lupus erythematosus

Hafez

Hassan

Teama

et al. 2020

Lupus

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Objective Lupus nephritis (LN) is closely associated with hyperuricemia, and uric acid is considered a risk factor for renal involvement in systemic lupus erythematosus (SLE). This study aimed to examine the association between serum uric acid (SUA) level and LN development and progression in SLE patients with normal renal function. Methods A total of 60 SLE patients with normal renal function from Ain Shams University Hospital were selected and assigned to group 1 (30 patients with LN) and group 2 (30 patients without LN). All patients were subjected to history taking, clinical examination, disease activity assessment based on SLE disease activity index (SLEDAI) and renal SLEDAI (SLEDAI-R) scores, and laboratory investigations, including as SUA, complete blood count, blood urea nitrogen (BUN), serum creatinine, creatinine clearance, urine analysis, protein/creatinine ratio, 24-h urinary protein excretion, Antinuclear antibodies (ANA), anti-dsDNA antibody, and serum complement (C3, C4). Results Disease duration, SLEDAI score, and SUA level were higher in group 1 than in group 2 (p < 0.001). SUA level was positively correlated with SLEDAI and SLEDAI-R scores, proteinuria, urinary casts, renal biopsy class, disease activity and chronicity indices, BUN level, and serum creatinine level but was negatively correlated with creatinine clearance (p < 0.05). SUA was a predictor of LN development in SLE patients (sensitivity, 83.3%; specificity, 70%). Conclusion SUA is associated with the development of lupus nephritis in patients with normal kidney function also SUA in-dependently correlated with disease activity and chronicity in LN.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 58%

Serum uric acid as a predictor for nephritis in Egyptian patients with systemic lupus erythematosus

Hafez

Hassan

Teama

et al. 2020

Lupus

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“…Yang et al 23 found that serum uric acid level was associated with the development of lupus nephritis and previously we have reported that serum uric acid level predicts increased kidney damage 9. In the same way, Ugolini-Lopes et al 24 found that serum uric acid levels <6.05 mg/dL at 12 months of follow-up were a predictor of good long-term renal outcome in lupus nephritis. Likewise, in the study by Sabio et al ,25 patients with hyperuricaemia presented a worse cardiovascular risk profile that included hypertension, obesity, high cholesterol levels, renal damage and metabolic syndrome; in addition, serum uric acid levels correlated with high levels of erythrocyte sedimentation rate, C reactive protein, fibrinogen and homocysteine.…”

Section: Discussionmentioning

confidence: 61%

“…Keeping uric acid levels low is recommended to avoid damage in SLE, as it has been observed in studies that increasing uric acid is related to anaemia in SLE,33 and also associated with the occurrence of stroke, peripheral neuropathy, hypertension, hyperlipidaemia and history of arterial thrombosis 7. Even normal values of uric acid have been associated with renal damage in patients with SLE 9 24…”

Section: Discussionmentioning

confidence: 99%

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

et al. 2020

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IntroductionSerum uric acid levels have been reported as predictors of cardiovascular, pulmonary, neurological and renal morbidity in patients with SLE. However, their role in cumulative global damage in these patients has not yet been determined.ObjectiveTo determine whether serum uric acid levels are associated with new damage in patients with SLE.MethodsThis is a longitudinal study of patients with SLE from the Almenara Lupus Cohort, which began in 2012. At each visit, demographic and clinical characteristics were evaluated, such as activity (Systemic Lupus Erythematosus Disease Activity Index-2K or SLEDAI-2K) and cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index or SDI). Treatment (glucocorticoids, immunosuppressive drugs and antimalarials) was also recorded. Univariable and multivariable Cox regression models were used to determine the impact of serum uric acid levels on the risk of new damage.ResultsWe evaluated 237 patients, with a mean age (SD) at diagnosis of 35.9 (13.1) years; 220 patients (92.8%) were women, and the duration of the disease was 7.3 (6.6) years. The mean SLEDAI-2K and SDI scores were 5.1 (4.2) and 0.9 (1.3), respectively. Serum uric acid level was 4.5 (1.4) mg/dL. Follow-up time was 3.1 (1.3) years, and 112 (47.3%) patients accrued damage during follow-up. In univariable and multivariable analyses, serum uric acid levels were associated with new damage (HR=1.141 (95% CI 1.016 to 1.282), p=0.026; HR=1.189 (95% CI 1.025 to 1.378), p=0.022, respectively).ConclusionHigher serum uric acid levels are associated with global damage in patients with SLE.

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“…We had also attempted stratified analysis by age, sex, and renal function, but we failed to identify an independent correlation between HUA and prognosis. A recent study from a small sample also detected that the serum UA level <6.05 mg/dL at 12 months can predict a positive long-term renal outcome (creatinine clearance ≥90.0 mL/min/1.73 m 2 within 7 years) in LN patients [ 32 ]. The reasons for the different results were that these two studies had different definitions of the primary endpoint, and used specific values of UA in Cox regression analysis, whereas our study directly used HUA as a variable in the regression.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Patterns and Outcomes in Patients with Lupus Nephritis and Hyperuricemia

Wen

Tang

Zhou

et al. 2022

JCM

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A limited number of large cohort studies have reported the clinicopathological characteristics and prognosis of patients with lupus nephritis (LN) and hyperuricemia (HUA). In this retrospective cohort study, 1297 LN patients were enrolled from January 1996 to December 2011 in the First Affiliated Hospital of Sun Yat-Sen University, and HUA occurred in 649 (50.04%) of these 1297 LN patients. Compared to patients without HUA, those with HUA presented with higher blood pressure and triglyceride levels, lower hemoglobin and serum albumin levels, worse renal function, more severe hematuria and proteinuria, higher lupus activity, and more positive antiphospholipid antibody. Pathologically, HUA cases presented more crescents, a higher degree of mesangial matrix, endothelial cell proliferation, and inflammatory cell infiltration. During the 52-month follow-up, the 5-year and 10-year incidence rates of renal endpoint events were 11.1% and 19.5% in the HUA group, and 8.3% and 13.8% in the non-HUA group, respectively (p = 0.073). In addition, the 5-year and 10-year mortality rates did not differ significantly between the HUA (12.0% and 18.2%) and non-HUA (12.2% and 17.5%) groups, respectively. This study verified that HUA was not an independent risk for poor clinical outcomes, and steroids that delay the deterioration of renal function did not affect the survival of these patients.

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Is serum uric acid a predictor of long-term renal outcome in lupus nephritis?

Cited by 12 publications

References 32 publications

Serum uric acid as a predictor for nephritis in Egyptian patients with systemic lupus erythematosus

Serum uric acid as a predictor for nephritis in Egyptian patients with systemic lupus erythematosus

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

Clinicopathological Patterns and Outcomes in Patients with Lupus Nephritis and Hyperuricemia

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