Serum uric acid and acute kidney injury: A mini review

Hahn, Kai; Kanbay, Mehmet; Lanaspa, Miguel A.; Johnson, Richard J.; Ejaz, A. Ahsan

doi:10.1016/j.jare.2016.09.006

Cited by 98 publications

(94 citation statements)

References 108 publications

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“…Serum creatinine is a measure of the glomerular filtration rate and is used as an index of renal function in clinical practice [37]. Hyperuricemia has also been acknowledged as an independent predictor for kidney injury [38,39]. Contrary to our expectations, none of the 2 renal biochemical markers were altered significantly in the farmers when compared to the reference group, suggesting integrity of the kidneys in farmers.…”

Section: Supplementary Materialscontrasting

confidence: 64%

Evaluation of the Effects of Agro Pesticides Use on Liver and Kidney Function in Farmers from Buea, Cameroon

Manfo

Mboe

Nantia

et al. 2020

Journal of Toxicology

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Agro pesticides are increasingly used worldwide to increase crop production. However, health hazards resulting from human exposure to these chemicals, especially from agricultural areas of developing countries have been a growing concern. The objective of this study was to evaluate the impact of occupational exposure to agro pesticides on the health of farmers in the Buea subdivision, which is one of the major agrarian areas in Cameroon. The study was transversal and involved 90 participants including 58 farmers using pesticides and a reference population of 32 men not involved in occupational use of agro pesticides. The participants were interviewed on agro pesticide use and their health status. Thereafter, blood samples were collected from the participants and used for the assessment of biochemical markers of the liver (alanine aminotransferase and aspartate aminotransferase) and the kidney (creatinine and uric acid) function. Results revealed that farmers frequently used insecticides, fungicides, and herbicides in their farming activities. Farmers reported several acute health symptoms related to pesticides use with the common ones being skin rash, eye irritation, and face burn. When compared to the reference population, the farmers showed significantly elevated (p<0.01) alanine aminotransferase activity. However, other parameters investigated were not affected significantly. These results suggested that farmers were exposed to 3 different classes of agro pesticides, which induced eye and skin affections. Pesticides exposure resulted in alterations of the liver function hence the increased serum alanine aminotransferase activity. Therefore, there is a need to sensitize the farmers on toxicity and liver alteration potential of agro pesticides and the importance of appropriate protective equipment that may minimize exposure.

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Section: Supplementary Materialscontrasting

confidence: 64%

Evaluation of the Effects of Agro Pesticides Use on Liver and Kidney Function in Farmers from Buea, Cameroon

Manfo

Mboe

Nantia

et al. 2020

Journal of Toxicology

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“…High levels of urinary UA (uUA) can cause kidney damage, which may be acute – for example, through stone formation (nephrolithiasis) or intrarenal obstruction (acute urate nephropathy) – or chronic, as in chronic (or gouty) nephropathy. Acute kidney injury can occur when UA concentrations in renal tubules reach supersaturation, which also depends on urine pH . Chronic nephropathy is thought to result from long‐term hyperuricosuria, in which UA concentrations may be below supersaturation.…”

Section: Introductionmentioning

confidence: 99%

Impact of non‐adherence on the safety and efficacy of uric acid‐lowering therapies in the treatment of gout

Hill‐McManus

Soto

Marshall

et al. 2017

Brit J Clinical Pharma

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AIMSDual-urate-lowering therapy (ULT) with xanthine oxidase inhibitor and uricosuric medications is a treatment option for severe gout. Uricosuric agents can cause hyperuricosuria, a risk factor for nephrolithiasis and acute uric acid nephropathy. The aims of the present study were to simulate the relationship between suboptimal drug adherence and efficacy, and to quantify the risk of hyperuricosuria in gout patients receiving mono-and dual-ULTs. METHODSThe impact of poor medication adherence was studied using two-compartment pharmacokinetic (PK) models based on published evidence, and a semi-mechanistic four-compartment pharmacodynamic (PD) model. The PKPD model was used to simulate mono and dual-ULT in gout patients with either under-excretion (lowered clearance) or overproduction of uric acid, with suboptimal adherence modelled as either a single drug holiday of increasing duration or doses taken at random. RESULTSSimulation results showed a surge in urinary uric acid occurring when dosing is restarted following missed doses. For underexcreters taking a 20-day drug holiday, the addition of 200 mg (or 400 mg) lesinurad to 80 mg febuxostat increased the percentage of patients experiencing hyperuricosuria from 0% to 1.4% (or 3.1%). In overproducers, restarting ULTs following drug holidays of more than 5 days leads to over 60% of patients experiencing hyperuricosuria. CONCLUSIONSSuboptimal medication adherence may compromise the safety and efficacy of mono-and dual-ULTs, especially in patients with gout resulting from an overproduction of uric acid. Clinicians and pharmacists should consider counselling patients with respect to the risks associated with partial adherence, and offer interventions to improve adherence or tailor treatments, where appropriate.British Journal of Clinical Pharmacology Br J Clin Pharmacol (2018) 84 142-152 142

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“…High serum uric acid concentrations may induce endothelial dysfunction by decreasing NO bioavailability, stimulating vascular smooth muscle cell proliferation and activating the renin-angiotensin system, which cumulatively lead to microvascular damage and dysfunction. 14,15 Higher levels of serum uric acid in a population of asymptomatic subjects were independently associated with endothelial dysfunction. 27 Moreover, in two prospective studies of healthy Chinese and Korean men high uric acid levels were found to be associated with development of retinal arteriolar narrowing 22 and microalbuminuria, 28 respectively.…”

Section: Discussionmentioning

confidence: 99%

“…11 Recently, uric acid has been a key area of focus as a potential causal factor in a multitude of diseases including but not limited to hypertension, nephropathy, atherosclerosis, heart failure and acute kidney injury. [12][13][14][15][16][17][18] The common pathophysiologic denominator of these pathways is thought to be oxidative stress and inflammation resulting from a hyperuricemic state. 19 In vitro studies demonstrated that the pro-oxidative and pro-inflammatory state induced by hyperuricemia leads to microvascular dysfunction through stimulation of vascular smooth muscle cell proliferation, inhibition of endothelial cell function and activation of renin-angiotensin system.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

Elevation in serum uric acid levels predicts favourable response to erlotinib treatment in patients with metastatic non‐small‐cell lung cancer

et al. 2019

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What is known and objective Erlotinib is a small molecule tyrosine kinase inhibitor which blocks the activation of epidermal growth factor receptor (EGFR), a transmembrane receptor that is upregulated in many cancer types. Inhibition of angiogenesis with consequent impairments in intratumoral microcirculation is one of the mechanisms through which EGFR inhibition halts the progression of cancer. A consequence of impaired microcirculation is intratumoral hypoxia, which results in increases in serum uric acid levels. The goal of this study was to investigate the relationship between serum uric acid levels and response to erlotinib in metastatic non‐small‐cell lung cancer (NSCLC). Methods A total of 56 patients with metastatic non‐small‐cell lung cancer who received erlotinib for a duration of at least 3 months were included in this retrospective cohort study. Demographic characteristics, progression status, baseline serum uric levels and 3‐month serum uric acid levels were recorded and analysed. Results and discussion Of the study population, 21 (37.5%) were female and 35 (62.5%) were male patients. No significant difference in above demographic characteristics was observed among exitus, survivor with progression and survivor without progression groups. Patients who responded favourably to erlotinib with no progression of their disease had significantly increased uric acid levels at 3‐month follow‐up (P = .01). Such a correlation was not observed if the patient was exitus (P = .47) or had progressed on erlotinib therapy (P = .19). What is new and conclusion In conclusion, this study is the first to demonstrate significant increases in serum uric acid levels in patients with metastatic NSCLC who responded favourably to erlotinib and had no progression under erlotinib therapy. Further studies are required to confirm and characterize serum uric acid as a novel biomarker in predicting the outcome in those with metastatic NSCLC.

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Serum uric acid and acute kidney injury: A mini review

Abstract: Graphical abstract

Cited by 98 publications

References 108 publications

Evaluation of the Effects of Agro Pesticides Use on Liver and Kidney Function in Farmers from Buea, Cameroon

Evaluation of the Effects of Agro Pesticides Use on Liver and Kidney Function in Farmers from Buea, Cameroon

Impact of non‐adherence on the safety and efficacy of uric acid‐lowering therapies in the treatment of gout

Elevation in serum uric acid levels predicts favourable response to erlotinib treatment in patients with metastatic non‐small‐cell lung cancer

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