Serum uric acid is not independently associated with plasma renin activity and plasma aldosterone in hypertensive adults

Mulè, Giuseppe; Castiglia, Antonella; Morreale, Margherita; Geraci, Giulio; Cusumano, C.; Guarino, L; Altieri, Dario C.; Panzica, Massimo; Vaccaro, Francesco; Cottone, Santina

doi:10.1016/j.numecd.2016.12.008

Cited by 11 publications

(9 citation statements)

References 39 publications

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“… 29 It should be noted that uric acid may primarily stimulate local RAAS rather than systemic RAAS, which would preclude any independent association between SUA and plasma renin activity or plasma aldosterone concentration in hypertensive patients. 30 …”

Section: Discussionmentioning

confidence: 99%

<p>Elevated Serum Uric Acid is Associated with Rapid Decline in Kidney Function: A 10-Year Follow-Up Study</p>

Kritmetapak¹,

Charoensri²,

Thaopanya³

et al. 2020

IJGM

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Purpose The long-term impact of changes in serum uric acid (SUA) concentration on the estimated glomerular filtration rate (eGFR) among the general population remains unclear. We investigated the longitudinal associations between changes in SUA and eGFR over 10 years in 1222 participants with baseline eGFR ≥60 mL/min/1.73 m 2 . Methods This was a 10-year retrospective cohort study conducted from 2007 to 2017. Rapid eGFR decline (defined as the highest quartile of change in eGFR between 2007 and 2017) and new-onset kidney disease (defined as an eGFR <60 mL/min/1.73 m 2 at a 10-year follow-up) were examined using multiple logistic regression analysis, adjusted for sex, age, body mass index, systolic blood pressure, SUA, fasting plasma glucose, serum total cholesterol, and triglyceride at baseline. Results SUA was inversely correlated with eGFR, and the slopes of the SUA-eGFR regression lines were consistently steeper in females than males. A significant inverse correlation was also observed between 10-year changes in SUA and eGFR in both sexes. Multivariate analysis showed that every 1 mg/dL increase in SUA from baseline was associated with higher risk of rapid eGFR decline and new-onset kidney disease (OR 1.25; 95% CI 1.14–1.33 and OR 1.40; 95% CI 1.26–1.49, respectively). Furthermore, the subjects in the highest SUA quartile (>6.0 mg/dL) had a 2.45 times higher risk of rapid eGFR decline (95% CI 1.51–3.42) compared to those in the lowest SUA quartile (<3.9 mg/dL). Conclusion Elevated baseline SUA is an independent risk factor for rapid eGFR decline and new-onset kidney disease in the general population.

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Section: Discussionmentioning

confidence: 99%

<p>Elevated Serum Uric Acid is Associated with Rapid Decline in Kidney Function: A 10-Year Follow-Up Study</p>

Kritmetapak¹,

Charoensri²,

Thaopanya³

et al. 2020

IJGM

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“…The pathogenesis of hypertension in DKD is complex and may also involve inappropriate sodium reabsorption, increased activity of the sympathetic nervous system and renin-angiotensin-aldosterone system (RAAS), endothelial cell dysfunction, and increased oxidative stress and inflammation. SUA has been implicated in several of these mechanisms in experimental models, including activating RAAS, the sympathetic nervous system, and mediating endothelial dysfunction, but the data are inconsistent and the relationships incompletely delineated (31,32). Further, there is increasing evidence that SUA may have a causal role in obesity and insulin resistance (33).…”

Section: Discussionmentioning

confidence: 99%

Elevated Serum Uric Acid Is Associated With Greater Risk for Hypertension and Diabetic Kidney Diseases in Obese Adolescents With Type 2 Diabetes: An Observational Analysis From the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study

et al. 2019

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Elevated serum uric acid (SUA) is increasingly recognized as a risk factor for kidney disease in adults with diabetes, but data in youth are limited. We hypothesized that elevated SUA predicts development of elevated urinary albumin excretion (UAE) and hypertension over time in teens with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS Serum creatinine, cystatin C, SUA, and the urine albumin-to-creatinine ratio (UACR) were assessed in 539 obese youth, ages 12-17 years, with T2D duration <2 years at baseline in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. Estimated glomerular filtration rate (eGFR) was calculated using creatinine and cystatin C. Hypertension was defined as systolic or diastolic blood pressure ‡130/80 mmHg and elevated UAE as UACR ‡30 mg/g. Cox proportional hazards models evaluated the relationship between SUA and outcome variables longitudinally over an average follow-up of 5.7 years, adjusting for age, sex, race/ ethnicity, BMI, HbA 1c , eGFR, ACE inhibitor/angiotensin receptor blocker use, and TODAY treatment group assignment. RESULTS At baseline, hyperuricemia (‡6.8 mg/dL) was present in 25.6% of participants, hypertension in 18.7%, and elevated UAE in 6.1%. During follow-up of up to 7 years, hypertension developed in 37.4% and UAE in 18.0%. Higher baseline SUA increased the risk of incident hypertension (hazard ratio [HR] 1.19, 95% CI 1.03-1.38, per 1 mg/dL increase in SUA) and elevated UAE (HR 1.24, 95% CI 1.03-1.48) in adjusted models. CONCLUSIONS Hyperuricemia was common in youth with T2D. Higher baseline SUA independently increased the risk for onset of hypertension and elevated UAE. Research is needed to determine whether SUA-lowering therapies can impede development of diabetic kidney disease and hypertension in T2D youth.

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“…In addition, RAAS can be indirectly activated by UA-mediated inflammatory status [23,69]. Some in vivo human studies showed a correlation between SUA and RAAS [70,71], while others did not [72,73]. A possible explanation for these inconsistent results is that most studies analyzed systemic RAAS activity and not specifically intrarenal RAAS.…”

Section: Biology Of the Association Between Ua And Hypertensionmentioning

confidence: 99%

Uric Acid and Hypertension: Prognostic Role and Guide for Treatment

Piani

Cicero

Borghi

2021

JCM

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The relationship between serum uric acid (SUA) and hypertension has been a subject of increasing interest since the 1870 discovery by Frederick Akbar Mahomed. Several epidemiological studies have shown a strong association between high SUA levels and the presence or the development of hypertension. Genetic analyses have found that xanthine oxidoreductase (XOR) genetic polymorphisms are associated with hypertension. However, genetic studies on urate transporters and Mendelian randomization studies failed to demonstrate a causal relationship between SUA and hypertension. Results from clinical trials on the role of urate-lowering therapy in the management of patients with hypertension are not uniform. Our study sought to analyze the prognostic and therapeutic role of SUA in the hypertensive disease, from uric acid (UA) biology to clinical trials on urate-lowering therapies.

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Serum uric acid is not independently associated with plasma renin activity and plasma aldosterone in hypertensive adults

Cited by 11 publications

References 39 publications

<p>Elevated Serum Uric Acid is Associated with Rapid Decline in Kidney Function: A 10-Year Follow-Up Study</p>

<p>Elevated Serum Uric Acid is Associated with Rapid Decline in Kidney Function: A 10-Year Follow-Up Study</p>

Elevated Serum Uric Acid Is Associated With Greater Risk for Hypertension and Diabetic Kidney Diseases in Obese Adolescents With Type 2 Diabetes: An Observational Analysis From the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study

Uric Acid and Hypertension: Prognostic Role and Guide for Treatment

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