The conundrum of hyperuricemia, metabolic syndrome, and renal disease

Abstract

The level of serum uric acid in human has been increasing over the last decades, and correlates with an increase prevalence of renal disease and metabolic syndrome. Understanding the role of uric acid in these conditions may provide clues for preventing the current epidemic of renal disease. Controversy still remains if hyperuricemia is simply a consequence or a cause of renal disease although epidemiological studies have attempted to resolve this issue. In this review, we discuss the clinical and experimental evidence for a causal role of hyperuricemia in renal diseases and potential relationships of hyperuricemia with metabolic syndrome.

Nicorandil, a Katp channel opener, alleviates chronic renal injury by targeting podocytes and macrophages

“…We found that uric acid level was elevated in the kidney, but not in the serum. Importantly, uric acid, a metabolite of xanthine oxidate, is also a prooxidant and may play a role in renal disease (11)(12)(13)(14). Hence, an elevation of intrarenal uric acid, observed in this study, could provide another source of oxidative stress.…”

The study of prevalence of hyperuricemia and metabolic syndrome in type 2 diabetes mellitus

“…1 Hyperuricemia or elevated serum uric acid levels (SUA) is a biochemical entity that is gaining increasing importance as it is found by some researchers to be not only a cardiovascular risk factor but also plays a role in development of renal and metabolic diseases. [2][3][4] Some reports on SUA and metabolic syndrome have noted that increased SUA concentration is associated with increased prevalence of some of the parameters of the metabolic syndrome like obesity, dyslipidemia and hypertension. 5,6 In these reports, the documented prevalence rates of hyperuricemia ranged from 13-19% with greater proportions of males having elevated levels of SUA compared to females.…”

Serum uric acid is associated with bone health in older men: A cross-sectional population-based study

“…Experimental, clinical, and epidemiologic evidence suggests that hyperuricemia may cause endothelial cell damage and hence play a role in the pathogenesis of certain disease processes such as cardiovascular disorders, (1,(3)(4)(5) chronic heart failure, (6) hypertension and progressive renal disease, (7)(8)(9) stroke, (10) type 2 diabetes mellitus, (11,12) insulin resistance, and the metabolic syndrome. (13)(14)(15) Conversely, it has been hypothesized that a mutation in the urate oxidase gene occurring early during hominoid evolution and resulting in higher serum UA levels provided an evolutionary advantage because high UA levels help to maintain blood pressure under low-salt dietary conditions. (16) Furthermore, there is emerging evidence that UA functions as an antioxidant combating oxidative stress associated with aging and disease.…”