Association between serum uric acid and chronic kidney disease in patients with hypertension: A multicenter nationwide cross‐sectional study

2019 ◽  
Vol 12 (4) ◽  
pp. 235-242 ◽  
Author(s):  
Wisit Kaewput ◽  
Charat Thongprayoon ◽  
Ram Rangsin ◽  
Prajej Ruangkanchanasetr ◽  
Tarun Bathini ◽  
...  
2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091922
Author(s):  
Li-Ping Guo ◽  
Qin Wang ◽  
Yu Pan ◽  
Yan-Lin Wang ◽  
Ze-Jin Zhang ◽  
...  

Objective To investigate the prevalence of hyperuricemia in patients at different stages of chronic kidney disease (CKD) and the association of serum uric acid (SUA) with several clinical factors in a retrospective cross-sectional study of non-dialysis CKD patients at two hospitals in Shanghai, China. Methods The prevalence of hyperuricemia in CKD patients and the association of SUA with other clinical factors were examined using analysis of variance, chi-squared test, multivariate analysis, and other statistical methods. Results A total of 663 CKD patients were enrolled, of which approximately 52% had hyperuricemia. CKD patients with hyperuricemia had lower hemoglobin and estimated glomerular filtration rate (eGFR) levels but higher blood urea nitrogen, serum creatinine, and serum phosphate levels than those without hyperuricemia. Serum uric acid level was positively associated with age, blood urea nitrogen , serum creatinine, cystatin C, and serum phosphate and negatively associated with hemoglobin and eGFR. In addition, CKD patients with anemia and hyperphosphatemia had a higher prevalence of hyperuricemia than those without anemia or hyperphosphatemia. Conclusions The prevalence of hyperuricemia increased with CKD progression supporting the use of urate-lowering treatment for patients with CKD stage 1 to 4.


2021 ◽  
Vol 28 (4) ◽  
pp. 225-233
Author(s):  
Bon San Koo ◽  
Hye-Jin Jeong ◽  
Chang-Nam Son ◽  
Sang-Hyon Kim ◽  
Gheun-Ho Kim ◽  
...  

2020 ◽  
Vol 66 (8) ◽  
pp. 1100-1107
Author(s):  
Sibel Gökçay Bek ◽  
Berna Üstüner ◽  
Necmi Eren ◽  
Zeynep Sentürk ◽  
Betül Kalender Gönüllü

SUMMARY BACKGROUND Hepcidin is an important regulator of iron homeostasis. OBJECTIVES This cross-sectional study was conducted to evaluate the association between hepcidin and components of metabolic syndrome in patients with chronic kidney disease (CKD). DESIGN AND SETTING 103 CKD patients and 59 healthy volunteers were included in the study from the University Hospital. METHODS Serum hepcidin levels were measured by enyzme-linked immunosorbent assay (ELISA) test. As for the study parameters, age, sex, body mass index, renal diseases, serum biochemistry, complete blood count, iron and total iron-binding capacity, ferritin, high-sensitive C-reactive protein (hsCRP), C- reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated. RESULTS The mean age of the patients was 58.63 ± 11.8 years. Hepcidin level was significantly associated with hypertension and higher uric acid levels (P < 0.05). There was a positive correlation between hepcidin and urea, uric acid, creatinine, ferritin, CRP, ESR, phosphorus, triglyceride, low-density lipoprotein (LDL), proteinuria and albuminuria in 24-hour urine collection. A negative correlation was found between hepcidin and estimated glomerular filtration rate (eGFR), hemoglobin, hematocrit, calcium, 25 OH vitamin D, pH, and bicarbonate levels. CONCLUSION Hepcidin, a well-known hormone regulator of iron metabolism, may play an important role in the pathogenesis of metabolic syndrome in patients with CKD, and further studies might delineate in-depth its potential as a promising early marker in these patients.


2020 ◽  
Vol 7 (2) ◽  
pp. 45-52
Author(s):  
Dineshowri Shrestha ◽  
Anil Baral ◽  
Kashyap Dahal ◽  
Juju Raj Shrestha ◽  
Rajani Hada

Introduction: Hyperuricemia is a cause and effect of chronic kidney disease (CKD), accelerates its progression and predisposes to acute kidney injury. Present study aimed to find out the outcome of Febuxostat treatment in hyperuricemic pre-dialysis CKD patients. Method: This was a cross sectional study conducted in Nephrology department, Bir hospital, Nepal, during from February 2019 to January 2020, among pre-dialysis CKD stage 3-5 non dialysis (ND) patients with serum uric acid (SUA) >7 mg/d L who were treated with Febuxostat 40 mg once a day and followed up at one, two and three months. The baseline SUA, creatinine, estimated glomerular filtration rate (eGFR) calculated by the modification of diet in renal disease (MDRD) equation compared with values at follow up and according to CKD stages. The adverse effects and liver enzymes were recorded. Result: There were total 50 patients, mean age 54.2±16.5 years, male 31 (62%).There were significant reductions of SUA from baseline of 8.9±1.4to 7.1±1.2 vs 5.9±0.9 vs 4.7±1.0) at one, two and three month respectively, p=0.000 and increment of eGFR (ml/min/1.73m2) from 29.6±15.0 to 31.6±16.0, 33.6±16.6, 34.1±17.1, p=0.000.And 41 (82%) patients achieved uric acid < 6 mg/dl at three month. Significant reduction of uric acid in all CKD stages and increment of eGFR in CKD stage 3 and 4 were observed. Adverse effects were epigastralgia in 5 (10%) and joint pain in 13 (26%). Conclusion: Febuxostat is an effective serum uric acid lowering drug in pre-dialysis chronic kidney disease patients with improvement of kidney function.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044905
Author(s):  
Xixi Yu ◽  
Cheng Zhu ◽  
Han Zhang ◽  
Ziyan Shen ◽  
Jing Chen ◽  
...  

ObjectiveTo explore the association between urbanicity and hyperuricaemia (HUA) and whether urbanicity is an independent risk factor for HUA in Chinese adults.DesignData analysis from a cross-sectional survey.Setting and participants8579 subjects aged 18 years or older were enrolled in the study from the 2009 wave of the China Health and Nutrition Survey to analyse the association between urbanicity and HUA. We divided them into three categories according to urbanisation index (low, medium and highly urbanised groups).Main outcome measuresHUA was defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women.ResultsThe prevalence of HUA in low, medium and highly urbanised groups was 12.2%, 14.6% and 19.8%, respectively. The independent factors influencing serum uric acid included age, gender, hypertension, diabetes, chronic kidney disease, drinking, obesity and community-level urbanisation index (β=0.016, p<0.001). The risk of HUA in the highly urbanised group was significantly higher than that of the low urbanised group (OR 1.771, 95% CI 1.545 to 2.029, p<0.001), even after adjusting for other covariates (OR 1.661, 95% CI 1.246 to 2.212, p=0.001). In a subgroup analysis, we found that age, gender, comorbidity (such as hypertension, diabetes, obesity and chronic kidney disease) and physical activity affected the association between urbanisation and the risk of HUA.ConclusionsOur findings suggest that living in highly urbanised areas is linked with higher risk of HUA independent of cardiometabolic and health-related behavioural risk factors, which have been shown to increase along with urbanisation.


Biomedicines ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 19
Author(s):  
Ashani Lecamwasam ◽  
Tiffanie M. Nelson ◽  
Leni Rivera ◽  
Elif I. Ekinci ◽  
Richard Saffery ◽  
...  

(1) Background: Individuals with diabetes and chronic kidney disease display gut dysbiosis when compared to healthy controls. However, it is unknown whether there is a change in dysbiosis across the stages of diabetic chronic kidney disease. We investigated a cross-sectional study of patients with early and late diabetes associated chronic kidney disease to identify possible microbial differences between these two groups and across each of the stages of diabetic chronic kidney disease. (2) Methods: This cross-sectional study recruited 95 adults. DNA extracted from collected stool samples were used for 16S rRNA sequencing to identify the bacterial community in the gut. (3) Results: The phylum Firmicutes was the most abundant and its mean relative abundance was similar in the early and late chronic kidney disease group, 45.99 ± 0.58% and 49.39 ± 0.55%, respectively. The mean relative abundance for family Bacteroidaceae, was also similar in the early and late group, 29.15 ± 2.02% and 29.16 ± 1.70%, respectively. The lower abundance of Prevotellaceae remained similar across both the early 3.87 ± 1.66% and late 3.36 ± 0.98% diabetic chronic kidney disease groups. (4) Conclusions: The data arising from our cohort of individuals with diabetes associated chronic kidney disease show a predominance of phyla Firmicutes and Bacteroidetes. The families Ruminococcaceae and Bacteroidaceae represent the highest abundance, while the beneficial Prevotellaceae family were reduced in abundance. The most interesting observation is that the relative abundance of these gut microbes does not change across the early and late stages of diabetic chronic kidney disease, suggesting that this is an early event in the development of diabetes associated chronic kidney disease. We hypothesise that the dysbiotic microbiome acquired during the early stages of diabetic chronic kidney disease remains relatively stable and is only one of many risk factors that influence progressive kidney dysfunction.


Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 15
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev ◽  
Harika Alpay ◽  
Assiya Kanatbayeva ◽  
Aigul Balmukhanova

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.


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