The Serum Uric Acid Level Is Related to the More Severe Renal Histopathology of Female IgA Nephropathy Patients

Choi, Won Jung; Hong, Yu Ah; Min, Ji Won; Koh, Eun Sil; Kim, Hyung Duk; Ban, Tae Hyun; Kim, Young Soo; Kim, Yong Kyun; Shin, Seok Joon; Kim, Seok Young; Yang, Chul Woo; Chang, Yoon-Kyung

doi:10.3390/jcm10091885

Cited by 9 publications

(4 citation statements)

References 42 publications

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“…Therefore, our study indicated that the TA-SUA offers a better predictor of renal prognosis than the baseline SUA level. However, SUA is reported to be related to more severe renal histopathology and worse prognosis in female IgAN patients ( Choi et al, 2021 ; Oh et al, 2020 ). At present, it is not clear why the serum uric acid level of women is more important than that of men, but it has been reported that estrogen can inhibit urate transporter 1, reduce serum uric acid level and promote urinary acid excretion ( Takiue et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Association of time-averaged serum uric acid level with clinicopathological information and long-term outcomes in patients with IgA nephropathy

Weng,

Fu,

Zhuo

et al. 2024

PeerJ

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Objective Whether serum uric acid (SUA) at baseline could been identiûed as a risk factor for progression in IgA nephropathy (IgAN) patients remains unclear, therefore, long- term SUA control levels must be monitored. We aimed to investigate the relevant factors affecting time-averaged SUA (TA-SUA) and to assess the prognostic value of TA-SUA in IgAN. Methods This retrospective study included 152 patients with IgAN. The relationships between TA-SUA and clinicopathological features and renal outcomes (defined as the doubling of the baseline serum creatinine level or end-stage renal disease) were analyzed in groups divided by quartiles of TA-SUA levels, the presence of hyperuricemia, and sex. Results Patients with high TA-SUA levels had higher levels of baseline SUA, blood urea nitrogen (BUN), triglycerides, serum C3 and serum C4 and were more likely to be male and have hypertension, proteinuria, poor renal function, and pathological injuries including high grades of tubular atrophy/interstitial fibrosis (T1–T2). These patients had a poorer prognosis compared with patients with low TA-SUA levels. The TA-SUA level was positively correlated with baseline age and BUN, triglycerides, serum C3, and serum C4 levels, and negatively correlated with baseline eGFR. Survival curve analysis indicated that persistent hyperuricemia was associated with significantly poorer renal outcomes than normo-uricemia in both men and women. The TA-SUA level also was an independent predictor of renal outcome in patients with IgAN, with optimal cutoû values of 451.38 µmol/L (area under the curve (AUC) = 0.934) for men and 492.83 µmol/L (AUC = 0.768) for women. Conclusions The TA-SUA level is associated with triglyceride level, complement component levels, renal function, and pathological severity of IgAN, and it may be a prognostic indicator in male and female patients with IgAN.

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Section: Discussionmentioning

confidence: 99%

Association of time-averaged serum uric acid level with clinicopathological information and long-term outcomes in patients with IgA nephropathy

Weng,

Fu,

Zhuo

et al. 2024

PeerJ

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“…Uric acid, the product of purine metabolism, is a white tasteless odorless crystalline, which is primarily cleared by the kidneys. Notably, abundant evidence has confirmed hyperuricemia, featured with an increase in serum uric acid, mediates renal impairment via a variety of mechanisms, which include oxidative stress, nitric oxide pathway alteration, insulin resistance (IR), fructose metabolism disorder, inflammatory activation, stimulation of the renin-angiotensin system, and endothelial dysfunction 6 , 22 , 23 . The UAR, a valuable and compositive index that reflects the status of metabolic disturbance, nutrition and inflammation, possess the advantages of could be acquired timely and easily from initial serum biochemical analyses with low extra health cost, might be a novel predictor for renal progression and contribute to targeted management in the IgAN population.…”

Section: Discussionmentioning

confidence: 99%

“…As the final product of purine metabolism, uric acid (UA) is associated with oxidative stress, inflammatory response and endothelial dysfunction [5]. To date, hyperuricemia, which is presented as elevated serum uric acid level and associated with metabolic derangement, has attracted widespread attention as a reliable prognostic indicator for IgAN progression [6,7], and may contributes to renal injury Ivyspring International Publisher through the activation of Wnt5a/Ror2 or the NADPH/ROS/ERk1/2 signaling pathway [8]. Albumin (ALB), synthesized by the liver, is a negative acute phase reactant whose level in the blood decreases during malnutrition and inflammation [9,10].…”

Section: Introductionmentioning

confidence: 99%

Uric acid-based ratios for predicting renal failure in Chinese IgA nephropathy patients

Qin,

Yang,

Wang

et al. 2023

Int. J. Med. Sci.

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Objective: The uric acid/albumin ratio (UAR), a novel, simple, and compositive laboratory biomarker, has recently attracted attention for predicting disease prediction and disease prognosis. However, whether uric acid-related biomarkers (especially UAR) could serve as prognostic indicator for IgAN is unclear. Methods : In this retrospective cohort study, biopsy-confirmed IgAN patients from 2009 to 2017 from West China Hospital were evaluated. The optimal cutoff value of UAR for renal outcome was defined using the Youden index by the area under receiver operating characteristic curve (AUC). The patients were then categorized into the high UAR group and the low UAR group. Renal endpoints were defined as progression to ESRD, eGFR decreased ≥50% of the baseline level, or initiation of renal replacement treatment. Kaplan‒Meier survival analysis and Cox regression analysis were used to identify factors influencing IgAN outcomes. Results: A total of 1143 patients with a median age of 33.0 (26.0-42.0) (44.2% men) were included in the study. The best cut-off UAR concerned with renal survival was determined to be 9.94 with a specificity of 77.5% and a sensitivity of 61.5% (J, 0.390; AUC, 0.750). Then, the patients were divided into two groups labelled as low and high UAR ratios (≥ 9.94 and <9.94, respectively). More severe clinical manifestations and pathological lesions were observed in the high UAR group. Multivariate Cox regression analysis after adjusted for important clinicopathological parameters manifested that a high UAR was an independent prognostic biomarker for IgAN. ( p = 0.036, HR =2.56, 95% CI: 1.07-6.16). Conclusion: UAR might be a novel predictor for renal progression and contribute to targeted management.

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“…

Hyperuricemia (HUA) is closely related with gout [1, 2], nephropathy [3,4], and cardiovascular risk [5]. Lacking the functional uricase, hominoids are the only mammals that cannot degrade urate [6].

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confidence: 99%

New Lupanes from Alstonia scholaris Reducing Uric Acid Level

Hu,

Zhao,

et al. 2023

Planta Med

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Twelve lupanes including three new compounds named alstoscholarilups A−C (1–3) were isolated from the leaves of Alstonia scholaris. Their structures were elucidated by spectroscopic analysis and ECD calculation. Structurally, compound 1 with a rare A ring-seco skeleton formed lactone and degraded C-3, while 2 with a 28-nor and 3 with a 29-nor-lupane skeleton supported the phytochemical diversity and novelty of the plant. Pharmacologically, compounds 4, 7, and 10 reduced the serum uric acid (UA) levels of mice significantly.

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The Serum Uric Acid Level Is Related to the More Severe Renal Histopathology of Female IgA Nephropathy Patients

Cited by 9 publications

References 42 publications

Association of time-averaged serum uric acid level with clinicopathological information and long-term outcomes in patients with IgA nephropathy

Association of time-averaged serum uric acid level with clinicopathological information and long-term outcomes in patients with IgA nephropathy

Uric acid-based ratios for predicting renal failure in Chinese IgA nephropathy patients

New Lupanes from Alstonia scholaris Reducing Uric Acid Level

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